“Las Vegas” NP Fraudulently Bills Medicare for ~$900M. Gets $300M

Did she pay off her student loans though?

Medicare needs tighter controls on paying for services and visits

It’s my understanding that Medicare rarely if ever asks questions and will just pay what the providers bill (at reduced amounts to be fair)

Chiropractors for example will often “double bill” medicare. Aka if someone comes in on a Thursday for chiro treatment, the chiro will bill for a Thursday and Friday visit. They get double the money

My brother has a small clinic in rural Mississippi that accepts Medicare. I’m surprised at this story - the government paperwork requirements are so onerous that he has to pay a separate full-time clerk and another account manager just to manage Medicare.

He makes a meager profit on Medicare but feels compelled to accept it because almost all of his patients over 55 have it (there are also apparently an outsized number of Mississippians who are disabled or on Medicare/medicaid for one reason even though they are in their working years).

The woman here either did not manage her paperwork, or worse, intentionally took money she wasn’t owed.

There needs to be changes to how the government manages Medicare. But it’s not “socialized medicine” even in the slightest. Besides there are some things that should have more of a “socialized” flavor and healthcare is one of the few IMO.

Ans each year Medicare drops the rate it reimburses. I know, I’m just like your brother. It’s insane and I am about to stop taking Medicare.

“Las Vegas” NP Bills Medicare for ~$900M. Gets $300M

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The woman here either did not manage her paperwork, or worse, intentionally took money she wasn’t owed.

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Dude.

You look like a damned fool offering this.

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He makes a meager profit on Medicare 

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Margins go up considerably when your input cost is zero.

He may disagree, but IMO any profit above 10-15% is too much. That’s what a restaurant (hopefully) makes off the meal you buy. Medicine offers just a different service. Not sure why the margins should be higher.

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But eventually they learned how to game the system. Now you couldn't find a doctor who'd want to get rid of it

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I'd be hard pressed to find one who would not want to get rid of it.

Medicare consistently underpays, over regulates, and is overly intrusive in the clinical setting. There is little that Medicare touches that doesn't get screwed up. E.g., Medicare was virtually solely responsible for the opioid crisis (requisite inclusion of formal visual analog pain scale documentation, reimbursement based on patient satisfaction wrt pain control, threats to withhold fees from facilities based on those results, etc.) which government eventually pinned on pharmaceutical companies.

The AMA is a completely different matter. The vast majority of its revenue is tied to CPT codes which medicare agrees to use exclusively. It's a deal with the devil, aligning the AMA with the federal government as opposed to physicians. At this point, the government is able to use that relationship to extort nearly anything from the AMA it desires (Obama care approval, for example)

Because CPT codes in today's computer systems are wholly unnecessary, the government's continued licensure payments to the AMA constitute nothing more than a bribe for good behavior and collusion against physician interests.

DC is just one ginormous, unmanageable racket.

Monopoly game money. Numbers that continually seem so large they become almost meaningless.

It’d probably be amazing to the “take care of me” types to learn they really don’t need billionaires to provide all their basic life needs if the money already coming in to Washington every year was simply managed responsibly and accounted for.

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My brother has a small clinic in rural Mississippi

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i'm gonna stop you right there boy, you don't have a brother. does your pretend brother read homoerotic literature to his pretend wife and children?