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WHY IS GOVERNOR & DEMOCRATS PROTECTING MEDICAID FRAUD ?
Posted on 7/10/18 at 6:45 am
Posted on 7/10/18 at 6:45 am
Article
Report
Article
Report
Article
quote:
What Purpera’s report said was auditors found 41 million paid claims totaling $2.4 billion from October 2015 through December 2017 that didn’t have valid provider identification numbers. They found more than 194,000 claims totaling $13 million where the provider type and a specialty code associated with it didn’t match. They identified $136 million in paid claims where a registry showed that a health provider wasn’t enrolled with the managed care organization making the payment. Another $587 million in paid claims involved health providers not linked to a managed care plan.
quote:
· Representative Lance Harris (R-Alexandria) recently sent a letter to the Governor requesting that Medicaid fraud legislation be considered in addition to tax revenue legislation in the upcoming 3rd Special Session on June 18th – and therefore combine spending reduction legislation with tax increases. The Governor denied the request.
quote:
there are some 83,000 Louisianans whose tax information differs from what’s on their Medicaid application by more than $20,000 a year, which is a spread that would make the vast majority of them ineligible to go on the state’s dole
6
Posted on 7/10/18 at 6:46 am to cajuncarguy
Because it is their voter base
This post was edited on 7/10/18 at 6:47 am
Posted on 7/10/18 at 6:52 am to cajuncarguy
All Medicaid is fraud
Don’t go to the hospital if you can’t afford it
Don’t go to the hospital if you can’t afford it
Posted on 7/10/18 at 6:54 am to cajuncarguy
quote:
WHY IS GOVERNOR & DEMOCRATS PROTECTING MEDICAID FRAUD ?
Because the Dimocratic party is the new plantation owner. They have to keep their slaves in line and instead of the whip, they use your tax money for massive FREE giveaways.
So pathetically sad that it is that way....even worse that the slaves are a willing participant in their own enslavement.
Posted on 7/10/18 at 7:00 am to cajuncarguy
quote:
What Purpera’s report said was auditors found 41 million paid claims totaling $2.4 billion from October 2015 through December 2017 that didn’t have valid provider identification numbers. They found more than 194,000 claims totaling $13 million where the provider type and a specialty code associated with it didn’t match. They identified $136 million in paid claims where a registry showed that a health provider wasn’t enrolled with the managed care organization making the payment. Another $587 million in paid claims involved health providers not linked to a managed care plan.
By the way...in our new world of corporate/government medicine, this coding usually isn't done by actual doctors who are either W2 employees or benefitless 1099 contractors with some corporate entity...which then employs high school grads or people with associates degrees to level and code charts after the fact in such a way as to maximize corporate profits.
Posted on 7/10/18 at 7:41 am to cajuncarguy
Turtle head has to run next year. He has to keep freeloaders on the free shite rolls so he can get them to vote for him so he can keep on giving them free shite. Working people pay for the free shite.
Posted on 7/10/18 at 7:56 am to Boatshoes
quote:
By the way...in our new world of corporate/government medicine, this coding usually isn't done by actual doctors who are either W2 employees or benefitless 1099 contractors with some corporate entity...which then employs high school grads or people with associates degrees to level and code charts after the fact in such a way as to maximize corporate profits.
Which is why most of this "fraud" is simply typos.
Posted on 7/10/18 at 8:34 am to BlackAdam
If they are intentionally being coded differently, that is fraud.
This post was edited on 7/10/18 at 8:37 am
Posted on 7/10/18 at 8:35 am to ILeaveAtHalftime
quote:
Because it is their voter base
Posted on 7/10/18 at 8:36 am to cajuncarguy
quote:
WHY IS GOVERNOR & DEMOCRATS PROTECTING MEDICAID FRAUD ?
Posted on 7/10/18 at 8:37 am to Boatshoes
83000 people committing a felony. Never change Louisiana.
Posted on 7/10/18 at 8:41 am to navy
A friend of mine is one of the top whistleblower Medicaid plaintiff attorneys in the US and he told me a couple of years ago as he was exploring entering the Louisiana market that we rank in the Top 5 for Medicaid fraud in the US. (I think at the time we were #3 with Florida being #1). He decided not to open up an office in Louisiana due to the political atmosphere with respect to Medicaid/Medicare fraud here and an overwhelmingly dysfunctional US Attorney's office across the state (particularly the EDLA).
Every state this attorney has concentrated his efforts have resulted in the Medicaid/Medicare fraud rates dropped by 12% in that state on average which speaks to his effectiveness as a watchdog.
Every state this attorney has concentrated his efforts have resulted in the Medicaid/Medicare fraud rates dropped by 12% in that state on average which speaks to his effectiveness as a watchdog.
Posted on 7/10/18 at 9:07 am to Drunken Crawfish
quote:
If they are intentionally being coded differently, that is fraud.
yes. And im sure a percentage of it is fraud, but the vast majority is typos. Minimum wage data entry clerks transpose cpt codes all the time.
The state is probably owed some money back, and in some cases providers were probably underpaid. To know the extent the charge has to be taken back to the physician's order.
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