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re: DOGE just got into Medicare and Medicare payments -

Posted on 2/5/25 at 6:53 pm to
Posted by NC_Tigah
Make Orwell Fiction Again
Member since Sep 2003
135706 posts
Posted on 2/5/25 at 6:53 pm to
quote:

Who do you think is auditing them and gets to look at our medical records?
The folks auditing them are far far far far more reviewed than the billing folks currently looking at your records
Posted by SammyTiger
Baton Rouge, LA
Member since Feb 2009
78301 posts
Posted on 2/5/25 at 6:54 pm to
quote:

Blinded Medicare claims data is publicly avaialble to anyone if you really want it. You don't need patient identifiers to uncover potential red flags of abuse.


Cool, and wouldn’t we all feel better knowing that’s all Elon has access to?
Posted by DTRooster
Belle River, La
Member since Dec 2013
8890 posts
Posted on 2/5/25 at 6:54 pm to
The purview is what the Orange Man Bad says it is


Beotch
Posted by troyt37
Member since Mar 2008
14680 posts
Posted on 2/5/25 at 6:54 pm to
quote:

sorry, I forget you are dumb. that was sarcasm. I thought putting “waste” in quotation marks would set that off.


Right, because I’m the one in here pissing my pants about something that can never and will never happen. I’m also losing my shite about a guy auditing an outrageously bloated and wasteful government agency, when he has literally built a fricking space program that is light years more efficient and about 10,000% cheaper than NASA. You’re a joke, friend. Quit while you’re behind.
Posted by the808bass
The Lou
Member since Oct 2012
125556 posts
Posted on 2/5/25 at 6:54 pm to
quote:

id they wanted KPMG to audit their finances they wouldn’t be able to give them access to medical records.


How many of those audits you been a part of?

ETA: when you bring in an auditor as a healthcare provider or insurance company, they’re not just auditing finances.
This post was edited on 2/5/25 at 6:55 pm
Posted by SammyTiger
Baton Rouge, LA
Member since Feb 2009
78301 posts
Posted on 2/5/25 at 6:55 pm to
quote:

The folks auditing them are far far far far more reviewed than the billing folks currently looking at your records


Removed or reviewed?
Posted by SammyTiger
Baton Rouge, LA
Member since Feb 2009
78301 posts
Posted on 2/5/25 at 6:55 pm to
quote:

How many of those audits you been a part of?


0

But if you have credible information a major health organization gives medical records to 3rs parties please let me know.

That would be a great case.
Posted by NC_Tigah
Make Orwell Fiction Again
Member since Sep 2003
135706 posts
Posted on 2/5/25 at 6:56 pm to
quote:

Removed or reviewed?
Are you trying to be cute?

Posted by SammyTiger
Baton Rouge, LA
Member since Feb 2009
78301 posts
Posted on 2/5/25 at 6:56 pm to
quote:

Are you trying to be cute?


I dont know what you’re trying to say.

Posted by Jbird
In Bidenville with EthanL
Member since Oct 2012
84938 posts
Posted on 2/5/25 at 6:57 pm to
Retard your government has given our data to contractors for years.

Same assholes have allowed breaches.

You are pissing your tampon over Elon exposing corruption and wasteful spending.

Posted by the808bass
The Lou
Member since Oct 2012
125556 posts
Posted on 2/5/25 at 6:58 pm to
quote:

But if you have credible information a major health organization gives medical records to 3rs parties please let me know.


This happens all the time. And there’s no lawsuit there, trip-and-fall lawyer.

quote:

The Privacy Rule allows covered providers and health plans to disclose protected health information to these “business associates” if the providers or plans obtain satisfactory assurances that the business associate will use the information only for the purposes for which it was engaged by the covered entity, will safeguard the information from misuse, and will help the covered entity comply with some of the covered entity’s duties under the Privacy Rule. Covered entities may disclose protected health information to an entity in its role as a business associate only to help the covered entity carry out its health care functions – not for the business associate’s independent use or purposes, except as needed for the proper management and administration of the business associate.

LINK
Posted by AURulz1
Member since May 2022
515 posts
Posted on 2/5/25 at 7:05 pm to
Man, you can't bring logic, rational thinking, deductive reasoning, or common sense into this discussion
Posted by NC_Tigah
Make Orwell Fiction Again
Member since Sep 2003
135706 posts
Posted on 2/5/25 at 7:11 pm to
quote:

I dont know what you’re trying to say.
What i'm "trying to say"?

Let's be clear. Okay?

It's my field.
So what I am saying is at one point, as a corporate owner, my company employed >250 billing personnel at any given time. I am keenly aware as to what their qualifications and requirements were. In our corporate terms, they were professionals. In DOGE terms, none would have made the first tranche of rejections.
Posted by SammyTiger
Baton Rouge, LA
Member since Feb 2009
78301 posts
Posted on 2/5/25 at 7:23 pm to
If you know all that then you know that doesn’t mean they get full access to medical files. They get access to what they need to do their job.

And again, just looking for some transparency that DOGE has limits to their access.
Posted by the808bass
The Lou
Member since Oct 2012
125556 posts
Posted on 2/5/25 at 7:53 pm to
quote:

If you know all that then you know that doesn’t mean they get full access to medical files. They get access to what they need to do their job.


Right. And that might include access to medical files. It certainly wouldn’t necessarily preclude access to medical files.

And no one seriously sees a KPMG employee walking into a UHC office and thinks “by god, I hope they have the appropriate access for their business associate purposes!!” The only reason you think that is because your arse is chapped over the election.
This post was edited on 2/5/25 at 7:54 pm
Posted by Hater Bait
Tuscaloosa & Gulf Shores
Member since Nov 2012
3129 posts
Posted on 2/5/25 at 8:15 pm to
A lot of it is doctors claiming to have performed surgery and other expensive procedures that they would never do. Like a psychiatrist claiming he performed nasal surgery on a patient. Bogus visits and things like that. I don’t know how an average recipient of Medicare could steal cash money from the program.
Posted by SammyTiger
Baton Rouge, LA
Member since Feb 2009
78301 posts
Posted on 2/5/25 at 8:19 pm to
quote:

Right. And that might include access to medical files. It certainly wouldn’t necessarily preclude access to medical files.


to some. the whole point isn’t that it isn’t just open access.

quote:

And no one seriously sees a KPMG employee walking into a UHC office and thinks “by god, I hope they have the appropriate access for their business associate purposes!!”


You would hope the legal department thinks that as the law requires systems and protocols in place to make sure they only get what they need.
Posted by DawgCountry
Great State of GA
Member since Sep 2012
32434 posts
Posted on 2/5/25 at 8:23 pm to
Still going strong after 13 pages but totally not mad at them finding the fraud

In 24 hrs the far left has become the party of transparency. Amazing how that happens
Posted by SammyTiger
Baton Rouge, LA
Member since Feb 2009
78301 posts
Posted on 2/5/25 at 8:29 pm to
quote:

Still going strong after 13 pages but totally not mad at them finding the fraud


yeah man, it could be in mad about the things i keep ranting about.

Posted by SmackoverHawg
Member since Oct 2011
30957 posts
Posted on 2/5/25 at 8:32 pm to
quote:

I don’t know how an average recipient of Medicare could steal cash money from the program.

Kickbacks from unnecessary procedures that were done or not done, pain meds in exchange for frequent and unnecessary procedures.
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