5/16/17: The right-wing fairy tale that government is always the problem and regulations are tools of Satan gets a tire iron between the eyes. Benjamin Poehling, a whistleblower with wide experience in healthcare, reports insurers have been “systematically bilking Medicare Advantage for years.”
__________
“Huge $
opportunities.”
__________
The Justice Department announces plans to sue UnitedHealth Group. Poehling claims UHG designed special computer programs to gather “evidence” allowing them to make patients appear sicker than they were. The government would pay $9,580 per year for a 76-year-old woman with diabetes and kidney failure. Then again, if the company could manage to show diabetes caused the kidney problem…
Then the government paid $12,902.
According to Poehling he and co-workers
were told to “mine” health data. In one email a company financial officer
mentions conditions which represent “huge $ opportunities.” “Let’s turn on the
gas!” he adds. The scheme, Poehling says, “was not about delivering better care
to members – the thing you would expect from a healthcare company. It was about
increasing the bottom line.”
Just for fun, because it bolsters the same point, peruse a list of top penalties levied against drug manufacturers in the United States. If you consider the top 22 examples, eight involve companies bilking Medicaid or Medicare. Total damages recovered in those cases: $6,640,000,000.
White collar criminals rarely go to prison; they just pay fines and go on with their business. By comparison, in 1997, Fair Wayne Bryant, steals a pair of hedge clippers. Under Louisiana’s “habitual criminal” statute, he is sentenced to life in prison.
BLOGGER’S NOTE: That sentence is upheld in August
2020.
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