Six Detroit area doctors indicted in $500M health care fraud • Hacker News Board

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

#51

Post by thaumasiotes » Fri, Dec 07, 2018, 9:29 AM UTC

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…

>> The feds could straightforwardly address the fentanyl problem by deillegalizing opiods, allowing reputable distribution to take over.

> I don't understand this at all. Most opioids are legal prescription drugs.

It's pretty straightforward. "Legal prescription drugs" are drugs you're not allowed to have without permission, and doctors face prosecution for giving you permission. This doesn't really promote safe availability -- it's specifically intended to do the opposite.

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

#52

Post by markdown » Fri, Dec 07, 2018, 10:06 AM UTC

pstuart wrote: post #22

dumbfoundded wrote: post #13

Earlier quoted context omitted.

It's crazy that cannabis is a schedule 1 drug. It's by far the safe way to manage chronic pain but federally illegal. I'm glad the states have the chutzpah to make it legal. The older I get the more I see how this country is run on money above everything else.

Crazier still is that kratom is getting lined up to be scheduled as well, when it is a proven safe tool for weaning people off of opiates.

Kratom is great as medicine to wean people off opiates.

However, it absolutely shouldn't be used in a recreational setting as it currently is, served in kratom bars (though they like to use the name "Kava" in an attempt to fly under the radar).

See /r/quittingkratom

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

#53

Post by lostlogin » Fri, Dec 07, 2018, 10:44 AM UTC

mgkimsal wrote: post #17

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.

and then... for legitimate cases... no dice. about 7 years ago my wife got sand in her eye - was problematic enough that we went to a local clinic. she wasn't going to go blind, but it was irritated enough that after flushing it out, it still looked... bad. and she indicated it was a bit sore, that she wanted to get home to just try to get to sleep. The doctor there offered a prescription for percocet. We said "no, n…

I know that you have likely shortened the story for reading, making the phone call sound different to how it really went, but if you want to set off alarm bells, ringing around asking about a script for strong pain meds is a way to do it.

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

#54

Post by mgkimsal » Fri, Dec 07, 2018, 10:59 AM UTC

lostlogin wrote: post #53

mgkimsal wrote: post #17

Earlier quoted context omitted.

and then... for legitimate cases... no dice. about 7 years ago my wife got sand in her eye - was problematic enough that we went to a local clinic. she wasn't going to go blind, but it was irritated enough that after flushing it out, it still looked... bad. and she indicated it was a bit sore, that she wanted to get home to just try to get to sleep. The doctor there offered a prescription for percocet. We said "no, n…

I know that you have likely shortened the story for reading, making the phone call sound different to how it really went, but if you want to set off alarm bells, ringing around asking about a script for strong pain meds is a way to do it.

when you're in intense pain, it's difficult to drive around to too many places (wife drove me to one), she called a few others, no one would even agree to schedule me to come in for a consultation/exam.

one office offered to schedule an appointment for about 4 weeks later, which I didn't take.

This situation has happened to me twice, both times this pain came out of nowhere, and first time it took me out of commission the better part of 4 days. Tried to get any medication (per above story) - nothing. Second time this happened, 2 years later, it lasted about 3 days, and I didn't even bother trying to get anything - just took a lot of OTC stuff. If this happened regularly, I might be able to figure out if there's some trigger to avoid, but... 2x in the last 6 years - hard to pinpoint!

I should add that this gave me a little bit of insight as to how people who live with chronic pain might feel all the time. Just a few days of that was maddening. Thinking it might be the 'new normal' - constant intense pain that rarely lapses - would really have been difficult to cope with, and I probably can emphathize (or is it sympathize?) a bit more with the prescription drug abuse situation.

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

#55

Post by 127001brewer » Fri, Dec 07, 2018, 11:52 AM UTC

It's been years since I have worked in this space, but, at the time, my group was charged with finding fraud committed by the providers and beneficiaries.

It was interesting work: we had data tapes shipped from CMS to us, we loaded the data into a Sybase database, and then used an analysis tool (which I can't recall the name of) to look for patterns of fraud - again, this was what now seems like a lifetime ago.

Is anyone currently working detecting Medicare and Medicaid fraud?

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

#56

Post by 127001brewer » Fri, Dec 07, 2018, 12:05 PM UTC

127001brewer wrote: post #55

It's been years since I have worked in this space, but, at the time, my group was charged with finding fraud committed by the providers and beneficiaries. It was interesting work: we had data tapes shipped from CMS to us, we loaded the data into a Sybase database, and then used an analysis tool (which I can't recall the name of) to look for patterns of fraud - again, this was what now seems like a lifetime ago. Is an…

One of the interesting things I there while there was develop a Java app and Python script to semi-automate the loading of tapes. Previously, a person had to load a few tapes into a magazine, place it into a machine, and manually load each tape - they had to sit in a secure room, wait for a tape to be loaded, and press a button to for the machine to load the next tape! Since this tape machine was old, there wasn't a lot of documentation, but I did find enough information to develop a script that loaded each tape, placed the data in the correct directory based on the tape's header information, and then emailed the data team once all the tapes in the magazine were loaded. It freed up that person to do meaningful work while the data tapes were being loaded.

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

#57

Post by christinamltn » Fri, Dec 07, 2018, 1:04 PM UTC

jekdoce wrote: post #41

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?

The problem with Fentanyl is dosage. It's really concentrated so if the manufacturing or separation into portions isn't well controlled then it's easy to end up with a much higher dose than expected. In a hospital with a known reliable source, you can get the right dose. When it's been cut into fake pain pills, it's easy to overdose.

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

#58

Post by ensignavenger » Fri, Dec 07, 2018, 2:20 PM UTC

ghufran_syed wrote: post #44

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…

This is exactly what the new article makes it sound like. I can only hope the feds have some hard evidence to back up their fraud claims and this isn't just a "see, we are doing something! Vote for us!" tactic. If the Feds allow the defendants to hire representation, I guess a jury will decide.

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

#59

Post by lotsofpulp » Fri, Dec 07, 2018, 2:31 PM UTC

CaliforniaKarl wrote: post #30

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.

Yeah, I remember when I got a wisdom tooth out, afterwards I got a prescription for something pretty strong. Vicodin, I think? It was years ago, and I don't remember. But I do remember that, even though I filled the prescription, I never ended up taking it. A few days of higher-dose ibuprofen (taken with food) was enough.

I got a prescription for hydrocodone after having a wisdom tooth taken out. I never bought it, and I didn't take any other medication either. There was mild discomfort for 12 to 18 hours, but it's crazy they're prescribing pain meds by default for no reason. And there was no instruction from the doctor to limit the pain med to only if absolutely necessary.

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

#60

Post by taway314 » Fri, Dec 07, 2018, 3:15 PM UTC

pupdogg wrote: post #4

Wow! Now it makes sense how Dr. Rajendra Bothra was well connected in the Indian Bollywood industry. I personally recall big Bollywood stars opting to stay over his house during their US trip instead of a local 5 star hotel...mind you, this was back in late 90s. I hadn't heard of him in a while thinking he might've retired or died. This is a shocker that they're taking him down while in his retirement. Feds do not ki…

That's what you get for making millions of dollars by taking advantage of people's trust and ruining their lives.