© Am Ang Zhang 2013
Latest Medicare Fraud Dallas, Texas, USA.
Federal authorities announced charges Tuesday in the largest healthcare fraud scam in the nation's history, indicting a Dallas-area physician on charges that he bilked Medicare of nearly $375 million and accusing him of sending "recruiters" to scoop up patients and get them to sign for treatments he never provided.
Prosecutors said Roy and his office manager in DeSoto, Teri Sivils, who was also charged, sent healthcare "recruiters" door-to-door asking residents to sign forms that contained the doctor's electronic signature and stating that his practice had seen them professionally in their own homes.
They also dispatched "recruiters" to a homeless shelter in Dallas, paying the recruiters $50 every time they coaxed a street person to a nearby parking lot and signed him up on the bogus forms.
Even when officials suspended his Medicare license last June, they said, Roy found a way around that by shifting his business to another company.
Claims that there is no socialised medicine in the US is unfounded an their expenditure is scary! Yet there are very talented people trying to scam the system and unfortunately that includes doctors that will even do stents and transplants.
Why can we not learn?
Private providers will not be hovering around if there is no money to be made.
Well, we are literally giving it away:
NHS Vault: Fair Playing Field
In 2007 Circle bought Nations Healthcare and with this came the Independent Sector Treatment Centre (ISTC) in Nottingham and the Midlands Centre in Burton and a facility in Bradford.
The staff who work in the treatment centre are seconded from the
under a Staff Services Agreement. It should be very clear that the
treatment centre is part of the complex and depends on the NHS hospital. University Hospital
The contract with Circle was extremely generous compared to the NHS hospital a short walk next door. The contract is known as a Minimum Take (MT) contract. Unlike Payment by Results (PbR, the payment system for NHS providers) Circle has a guaranteed income known as the "minimum take" and this means that commissioners pay the treatment centre even if they treat fewer than 95% of the patients they are contracted to treat. Further, the commissioners pay national tariff plus 22% for all activity up to 105% of plan and are paid national tariff for any activity over 105%.
The last full Annual Report from Circle is for the year ending 31 Dec 2011 (pdf). This report states that the
Most of the 87,340 patients of the
The contract for the
Nottingham University Hospital was one of the original bidders for the tender, and considering it provides the staff, does the same work at tariff, and is right next door to the treatment centre, it would appear to be a no brainer that they would get the contract. Details of the contract are currently not available, so we do not know if Circle will be paid at tariff, or on a minimum take. If the contract is on the former (tariff), then it is difficult to see how the ISTC can make a profit (and difficult for Circle to have a sustainable future). If it is the latter (minimum take) then this will go against government policy of a fair playing field.
Read the full blog here: Fair Playing Field
No full privatisation:
So nobody in their right mind would want to privatise the NHS. There is certainly more money to be made if it remained in the public domain.
For a long time, private providers only have consultants working for them to provide the specialist care. They are now moving into primary care to basically corner the market.
Business is business!!!
But the sums are somehow wrong: if the private providers are making money and the GP commissioning teams have a limited pot and that Consultants working for the likes of BMI hospitals have a 300% increase in pay compared to old NHS Hospital pay scale, either tax payers are going to be forking out more and more money or someone is not going to get their treatment.
Is some politician heading for a top job with the likes of GHG or Bupa? Only time will tell and history told us it won’t be long: less than 2 years.
NHS: Manipulation or Fraud?
Are going to more Health Care fraud like with the US?
Are going to more Health Care fraud like with the US?
In the current push for applying market principles, the NHS is in serious danger of paying dearly for unnecessary treatment and worse, fraudulent claims by the new “suppliers” in the market place.
Or was it just manipulation?
Serco, which had a turnover of £4.6 billion in 2011 and is poised to win new contracts from the NHS under the changes introduced by the Health and Social Care Bill, made some doctors work double 13 hour shifts overnight and other staff work 11 hour daytime shifts.
Inspectors made unannounced visits to the company’s call centre in
and five clinics during April and
May. They found Serco was in breach of
four of the eight essential standards, including failing to protect vulnerable
adults and children from abuse. Truro
Inspectors found the company had been manipulating its daily performance reports by altering incorrect entries which showed the service was failing to hit its targets. But it did not carry out similar checks on the accuracy of entries showing it had hit its targets – and inspectors found two examples of failed calls which had been wrongly classified as achieved.
BBC 20 May 2008
“A dentist and his wife who stole more than £30,000 from the NHS by claiming money for treatment never given to patients have been jailed.
Newton Johnson, 52, and his wife Judith, 51, also claimed for treatment for "phantom" patients, which included the name of a family pet dog.