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Six Detroit area doctors indicted in $500M health care fraud

fox2detroit.com

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Re: Six Detroit area doctors indicted in $500M health care fraud

#41

Post by jekdoce »

mindslight wrote: post #8

> "The damage that opioid distribution has done to our community and to the United States as a whole has been devastating" said U.S. Attorney Schneider I guess scapegoat big pharma is successfully finding their own scapegoats! The feds could straightforwardly address the fentanyl problem by deillegalizing opiods, allowing reputable distribution to take over. And then society could maturely deal with addiction as a pe…

They regularly give Fentanyl to pregnant women during labor. We know some of it crosses the placenta and enters the baby. Does anyone know why this is OK?

Re: Six Detroit area doctors indicted in $500M health care fraud

#42

Post by jekdoce »

coding123 wrote: post #35
danans wrote: post #14

If true, $500M of fraud (over only 5 years!) is hard to fathom considering it is a small clinic. I'm wondering how it wasn't discovered before it got to this level. You'd think that even $100M would have set off alarms somewhere.

I recall a few years back on some radio show probably OPB they just started recently to aggregate and chart all of the billing codes from every doctor in the nation, specifically related to medicare billing. It was at that point that they just started to find fraud. So this is a new thing that they can do, and I guess this is one of the outcomes. I can't wait for them to do this to the military black budget one day.

I wonder if they use Palantir software for the analysis?

Re: Six Detroit area doctors indicted in $500M health care fraud

#43

Post by trhway »

hn_throwaway_99 wrote: post #40
mindslight wrote: post #8

> "The damage that opioid distribution has done to our community and to the United States as a whole has been devastating" said U.S. Attorney Schneider I guess scapegoat big pharma is successfully finding their own scapegoats! The feds could straightforwardly address the fentanyl problem by deillegalizing opiods, allowing reputable distribution to take over. And then society could maturely deal with addiction as a pe…

> The feds could straightforwardly address the fentanyl problem by deillegalizing opiods, allowing reputable distribution to take over. And then society could maturely deal with addiction as a personal medical problem. I don't understand this at all. Most opioids are legal prescription drugs. The problem is that they are highly addictive, so despite trying deal with addition as a "personal medical problem", which is…

Personal medical problem would be treated by a doctor - ie. methadone, etc. Instead it is treated as a personal vice problem - ie. dealers/LEO instead of doctors.

Re: Six Detroit area doctors indicted in $500M health care fraud

#44

Post by ghufran_syed »

I'm a little confused - so if the docs "just gives narcotics without considering alternatives", then that's supposed to be WRONG and encouraging addiction. But if the doc feels other potentially beneficial treatments such as facet joint injections should be tried first, then they are accused of coercing the patient into an unnecessary procedure, essentially bribing then with narcotics. Damned if you do and damned if you don't...

Re: Six Detroit area doctors indicted in $500M health care fraud

#45

Post by _Nat_ »

HillaryBriss wrote: post #34
danans wrote: post #14

If true, $500M of fraud (over only 5 years!) is hard to fathom considering it is a small clinic. I'm wondering how it wasn't discovered before it got to this level. You'd think that even $100M would have set off alarms somewhere.

interesting that only about $10 million was fraudulently billed to a private company (blue cross/blue shield), and pretty much all the rest was billed to state and federal governments. maybe this is reading too much into it, but might this be evidence that government health care funds are poorly managed and pay out too much, too often, asking too few questions in the process?

What'd be the argument for that interpretation?

To note it, the article's figures are for submitted claims, not for approved claims.

Re: Six Detroit area doctors indicted in $500M health care fraud

#46

Post by 0x8BADF00D »

nickpsecurity wrote: post #15
akamel wrote: post #10

Earlier quoted context omitted.

Use them only when you need them. I was really annoyed when my wife’s doctor freely prescribed her oxi after her delivery even though my wife never asked for it and never showed any sign of needing it. Having free flowing prescriptions is how we end up with so many addicts.

I second this. I did this for my surgeries. If I took meds at all, I took them only early when likely pain was highest on in minimal, prescribed dose. Then as little as I could from that moment forward just enduring the discomfort, being careful about how I moved, etc. I got over it. Sometimes, the pain was low enough for OTC drugs should I have wanted to use them. Good way to avoid getting addicted.

I did something similar when I broke my ribs. I was prescribed Vicodin and Ibuprofen. I’d only take the minimum amount of Vicodin twice a week, and the other days would use Ibuprofen only. I also made sure I never took more than the minimum required dose two days in a row.

Re: Six Detroit area doctors indicted in $500M health care fraud

#47

Post by Omniusaspirer »

CaliforniaKarl wrote: post #3

Ugh. I’m going on for surgery next Thursday, for a laparoscopic partial colon resection, and one of the things I’m most worried about will be post-surgery pain killers. Hearing stories about excessive pain killer use and prescription really make me want to avoid them, but on the other hand I’ll need to be up & moving around ASAP to speed my recovery, and pain would get in the way of that.

I work as a nurse on a general surgery floor- exactly where you'll be after you leave the PACU. Your procedure is planned laparoscopic, which will considerably lessen your pain and recovery time. I've had several patients in your situation not take any opiates at all. Ask your physicians to consider a regimen of scheduled ketorolac or ibuprofen, acetaminophen, and gabapentin. Any opiates will be prescribed PRN (as needed), and generally will only be offered if you ask for them. As you alluded to, your safest bet pain-wise is to get the non-opiates on board first and only take opiates as required to facilitate your getting up and walking around- an essential part of your recovery.

As a disclaimer, you may have poor liver or kidney function which would contraindicate some of the medications I mentioned, your surgical team will make that call.

Re: Six Detroit area doctors indicted in $500M health care fraud

#48

Post by qaq »

jekdoce wrote: post #42
coding123 wrote: post #35

Earlier quoted context omitted.

I recall a few years back on some radio show probably OPB they just started recently to aggregate and chart all of the billing codes from every doctor in the nation, specifically related to medicare billing. It was at that point that they just started to find fraud. So this is a new thing that they can do, and I guess this is one of the outcomes. I can't wait for them to do this to the military black budget one day.

I wonder if they use Palantir software for the analysis?

Why? Outside of Palantir being extremely good at positioning itself as a product and services company vs a consulting shop that they truly are (with obvious significant boost to valuation this gives them).

Re: Six Detroit area doctors indicted in $500M health care fraud

#49

Post by CPLX »

HillaryBriss wrote: post #34
danans wrote: post #14

If true, $500M of fraud (over only 5 years!) is hard to fathom considering it is a small clinic. I'm wondering how it wasn't discovered before it got to this level. You'd think that even $100M would have set off alarms somewhere.

interesting that only about $10 million was fraudulently billed to a private company (blue cross/blue shield), and pretty much all the rest was billed to state and federal governments. maybe this is reading too much into it, but might this be evidence that government health care funds are poorly managed and pay out too much, too often, asking too few questions in the process?

Or it’s evidence that they exploited a population that doesn’t have private health insurance.

Re: Six Detroit area doctors indicted in $500M health care fraud

#50

Post by barking »

koolba wrote: post #6

> Officials said the defendants prescribed opioid medications to induce patients to visit the office, then in order to get them, they had to undergo ancillary services, including painful facet joint and facet block injections. This is disgusting on so many levels. If this is true I hope they throw the book at all of them and anyone else involved as well.

The doc who's 77 has lived his life and enjoyed the fruits of his crimes. No matter happens now he'll finish ahead.
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