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Anyone have experience investigating Medicaid/Medicare fraud?

Posted on 11/8/20 at 5:59 pm
Posted by Strannix
District 11
Member since Dec 2012
48915 posts
Posted on 11/8/20 at 5:59 pm
Are the payments service providers receive from the government public information? Or how can I drop a dime on them, research shows you can file a claim if you're an aggrieved party which I am not.
This post was edited on 11/8/20 at 6:46 pm
Posted by fightin tigers
Downtown Prairieville
Member since Mar 2008
73681 posts
Posted on 11/8/20 at 6:05 pm to
quote:

There are several ways you can alert the Louisiana Department of Health for investigation and swift punishment:
1. Call toll-free 1.800.488.2917 for Provider Fraud complaints.
    Call toll-free 1.888.342.6207 for Recipient Fraud complaints.

Posted by Nicky Parrish
Member since Apr 2016
7098 posts
Posted on 11/8/20 at 6:07 pm to
Any Doctor’s office that accepts Medicaid/Medicare could be investigated.
You know they are ordering any and every kind of test Medicaid/Medicare will cover.
Posted by btforlsu
Member since Jan 2006
196 posts
Posted on 11/8/20 at 6:15 pm to
Attorney generals office has a Medicaid/Medicare fraud division.
Posted by Beessnax
Member since Nov 2015
9144 posts
Posted on 11/8/20 at 6:16 pm to
They have some whistle-blower incentives.
Posted by FunkyFreshFranklin
ECA
Member since May 2008
260 posts
Posted on 11/8/20 at 6:19 pm to
quote:

Any Doctor’s office that accepts Medicaid/Medicare could be investigated. You know they are ordering any and every kind of test Medicaid/Medicare will cover


This. I’m a dentist and I see it all the time
Posted by OweO
Plaquemine, La
Member since Sep 2009
113946 posts
Posted on 11/8/20 at 6:23 pm to
I don't have experience, but I feel comfortable saying if everyone committing medicaid/medicare fraud was exposed at once, people would probably be shocked by how common it is.

The only reason I say this is because having to deal with bullshite when it comes to getting a wheelchair, there is a bunch of bullshite and they are not that excited when someone has regular insurance. And I couldn't just go in tomorrow and say "okay, this is what I need, i'd like to order it and have it shipped to my house".

If I ever need new batteries, I go to interstate batteries. Buy the same exact battery for about $175 (per battery, it requires 2) less than they sell them. And when I tell them where I go (I do that just to see their response), they give me some bullshite like "from now on, don't go there. Its best if you get the batteries from us and let us put them in so you know there will be no problems".
Posted by soccerfüt
Location: A Series of Tubes
Member since May 2013
65677 posts
Posted on 11/8/20 at 6:26 pm to
quote:

I’m a dentist and I see it all the time
A peek into your world-

“To be a dentist!”

Posted by RD Dawg
Atlanta
Member since Sep 2012
27298 posts
Posted on 11/8/20 at 6:34 pm to
Not sure but my old college roomie got busted for it big time.

Didn't go to jail but cost em almost everything he had.Had to flip on his partner to avoid jail time.

As the old saying goes: His ambition exceeded his intelligence...always a recipe for disaster.
Posted by tgrbaitn08
Member since Dec 2007
146214 posts
Posted on 11/8/20 at 6:39 pm to
quote:

Anyone else have experience investigating Medicaid/Medicare fraud?



Contact the state attorney general office
Posted by OysterPoBoy
City of St. George
Member since Jul 2013
35105 posts
Posted on 11/8/20 at 6:42 pm to
All you need is Benford's Law.
Posted by eng08
Member since Jan 2013
5997 posts
Posted on 11/8/20 at 7:14 pm to
Friends did the same, also depended on the brand power chair. Some were more sensitive to different parts than others.
Posted by USMEagles
Member since Jan 2018
11811 posts
Posted on 11/8/20 at 8:01 pm to
I'm sure there's a hotline for that, but...

On a net basis I think Medicaid and particularly Medicare are ripping off providers, not vice-versa. Yeah, there are scammers out there, but their transgressions are dwarfed by the money the public insurance systems owe but will never pay.

I don't just mean the price controls they impose, which are actually pretty reasonable. I mean the bureaucratic foot-dragging they impose on doctors and hospitals who basically have no choice but to serve their patients.

You can seriously save a Medicare / Medicaid's patient's life and Palmetto GBA probably won't pay you. I'm honestly not sure I ever got those assholes to pay a claim.
Posted by Kafka
I am the moral conscience of TD
Member since Jul 2007
141905 posts
Posted on 11/8/20 at 8:08 pm to
no fraud here

falls within statistical possibility

move on
Posted by LEASTBAY
Member since Aug 2007
14285 posts
Posted on 11/8/20 at 8:38 pm to
They are audited and many end up having to pay money back.
Posted by UnitedFruitCompany
Bay Area
Member since Nov 2018
3373 posts
Posted on 11/8/20 at 9:31 pm to
Yeah, sadly. Here's a true statement: the top 5 doctors in medicare reimbursements in any state usually end up in the crosshairs of the federales. Especially in the south.
Posted by tigergirl10
Member since Jul 2019
10310 posts
Posted on 11/8/20 at 11:41 pm to
quote:

when it comes to getting a wheelchair
You’re in a wheelchair? Oh my goodness, I’m sorry, I didn’t know.
Posted by DWaginHTown
Houston, TX
Member since Jan 2006
9858 posts
Posted on 11/8/20 at 11:46 pm to
Posted by SuperSaint
Sorting Out OT BS Since '2007'
Member since Sep 2007
140462 posts
Posted on 11/8/20 at 11:52 pm to
quote:

to OweO


quote:

You’re in a wheelchair? Oh my goodness, I’m sorry, I didn’t know.



Posted by dgnx6
Baton Rouge
Member since Feb 2006
68607 posts
Posted on 11/9/20 at 12:20 am to
Nope fraud doesn't happen.

Joe Biden
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