Healthcare Fraud - Who Can You Trust?

Tony Nathanson

Tony Nathanson

Well-known member
The defendants, who included 90 doctors and other healthcare professionals, were involved in $6.5 billion worth of fraud that involved false claims and resulted in significant harm to patients, the Justice Department announced Tuesday.
Officials highlighted one defendant who they claim rubber stamped a student's cardiovascular test as normal without alerting the family that his heart was enlarged. The 18-year-old college basketball player, Kaiden Francis, died weeks later during a workout.

The money issue is not what bothers me the most. It's the harm to one's health. I've experienced this on three occasions; that's why I'm so wary when a doctor or dentist suggests a drug, test, or treatment.

www.yahoo.com

Trump administration charges 455 people, including doctors, with $6.5 billion in healthcare fraud

In the Trump administration’s latest effort to crack down on fraud, the Justice Department on Tuesday unveiled charges against 455 people for their alleged participation in healthcare fraud and opioid...
www.yahoo.com www.yahoo.com

Reminded me of this doctor who owned his own cancer clinic & diagnosed many patients with cancer who didn't have cancer. Some died of the treatment which included heavy doses of chemotherapy (which he profited from big time - he also owned his own pharmacy & drug company) which -- as the doctor said -- would increase their chances of a cure. And many who survived lost all their teeth & suffered constant fractures due to bone loss:

Farid Fata - Wikipedia

en.wikipedia.org en.wikipedia.org


I'm surprised the victims' loved ones didn't take him out. Prison is way too lenient for him. If my loved one was his victim, he would never make it to trial & I'd be the one serving time in prison.
 
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Tony Nathanson said:
The defendants, who included 90 doctors and other healthcare professionals, were involved in $6.5 billion worth of fraud that involved false claims and resulted in significant harm to patients, the Justice Department announced Tuesday.
Officials highlighted one defendant who they claim rubber stamped a student's cardiovascular test as normal without alerting the family that his heart was enlarged. The 18-year-old college basketball player, Kaiden Francis, died weeks later during a workout.

The money issue is not what bothers me the most. It's the harm to one's health. I've experienced this on three occasions; that's why I'm so wary when a doctor or dentist suggests a drug, test, or treatment.

www.yahoo.com

Trump administration charges 455 people, including doctors, with $6.5 billion in healthcare fraud

In the Trump administration’s latest effort to crack down on fraud, the Justice Department on Tuesday unveiled charges against 455 people for their alleged participation in healthcare fraud and opioid...
www.yahoo.com www.yahoo.com

Reminded me of this doctor who owned his own cancer clinic & diagnosed many patients with cancer who didn't have cancer. Some died of the treatment which included heavy doses of chemotherapy (which he profited from big time - he also owned his own pharmacy & drug company) which -- as the doctor said -- would increase their chances of a cure. And many who survived lost all their teeth & suffered constant fractures due to bone loss:

Farid Fata - Wikipedia

en.wikipedia.org en.wikipedia.org


I'm surprised the victims' loved ones didn't take him out. Prison is way too lenient for him. If my loved one was his victim, he would never make it to trial & I'd be the one serving time in prison.
Click to expand...

Tony this too is true, so many obstacles.
 
I often hear, "Check out a doctor before you let him treat you, talk to his receptionist & assistants."
Uh, no. That won't help. Checking out a doctor will only provide limited, useless information due to privacy laws. And talking to his receptionist or assistant is even more useless. The doctor or dentist is the one who signs her paychecks; she won't stay employed if she's honest.
 
I guess I have something that might not be so much about fraud as it is about a physician trying to ring up the cash register for something unnessary.

Long story short, I had an CT scan without contrast about 2 months ago and they found a 7mm nodule on my upper left lung. Beh, says I. The size of a pencil eraser.
Anyway, my insurance company wanted me to schedule with a pulmonologist, which I did. He told me that the nodules are known to go away, stay the same or grow but all that said, he’d schedule me for another scan in a couple of months just to see what it’s going to do.

Now for the first cash register ringing.
The good doctor asked me about any phlegm buildup and I said yup, all my life but I’m getting rid of a lot of it by using my nebulizer w/ a small dose of saline solution. Note: it works extremely well.
The doc then gave me “that look” and said he’d rather I did something different for my nebulizer and gave me a scrip that two weeks later, had me going to my cardiologist because of all the heart palpitations. Yup, it was the scrip and I went back to my saline solution,
The Doctor still cashed in for the scrip and as it stood, so did the cardiologist.

Ring up number 2.
So, I knew that the Doctor said that I’d have to do another CT scan to see if there’s any growth but instead, I get a call from his office for a pulmonary function test. Huh? Says I.
On Monday, I called his office and spoke to whomever it was I spoke to and told her I was to get a CT scan so somebody is putting the cart before the horse.
I told her that I absolutely know HOW and HOW MUCH I am breathing but I just wanted to know for “How Much” LONGER I was going to BE breathing.
She said they’d get back to me within 24-36 hours but meanwhile, for two days they called me wanting a reply about making my appointment for the Function test. NO says I. Twice. You can’t ring the cash register if I’m not going to even make a reservation. Says I.

Finally, They called me on Wednesday and set an appointment for a Contrast CT scan on Friday afternoon and followed it up by telling me that I can’t have any caffeine before the scan. HUH? NO CAFFEINE and my appointment isn’t until 1545? (3:45 PM)

To wit, I know they’re taking out some revenge on me by denying me coffee for not letting them ring up that function test. Dr. Google says the function test runs about 1,200 + dollars for about 30 minutes worth of time. Technological prostitution says I and the only one normally enjoying it is the doctor but not THIS time !!!
 
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Tony Nathanson said:
I often hear, "Check out a doctor before you let him treat you, talk to his receptionist & assistants."
Uh, no. That won't help. Checking out a doctor will only provide limited, useless information due to privacy laws. And talking to his receptionist or assistant is even more useless. The doctor or dentist is the one who signs her paychecks; she won't stay employed if she's honest.
Click to expand...
Asked a couple of dentists how much a procedure will cost and both of them denied knowing and told me to ask at the reception desk.

Every single working person knows how much a job is going to make him or her or how much per hour they’re working for and no one can tell me that a doctor is any different.
 
Bobby Cole said:
Asked a couple of dentists how much a procedure will cost and both of them denied knowing and told me to ask at the reception desk.

Every single working person knows how much a job is going to make him or her or how much per hour they’re working for and no one can tell me that a doctor is any different.
Click to expand...
Doctors & dentists distance themselves from anything to do with money - as far as possible. They hand off that info to other employees.
 
Bobby Cole said:
I guess I have something that might not be so much about fraud as it is about a physician trying to ring up the cash register for something unnessary.

Long story short, I had an CT scan without contrast about 2 months ago and they found a 7mm nodule on my upper left lung. Beh, says I. The size of a pencil eraser.
Anyway, my insurance company wanted me to schedule with a pulmonologist, which I did. He told me that the nodules are known to go away, stay the same or grow but all that said, he’d schedule me for another scan in a couple of months just to see what it’s going to do.

Now for the first cash register ringing.
The good doctor asked me about any phlegm buildup and I said yup, all my life but I’m getting rid of a lot of it by using my nebulizer w/ a small dose of saline solution. Note: it works extremely well.
The doc then gave me “that look” and said he’d rather I did something different for my nebulizer and gave me a scrip that two weeks later, had me going to my cardiologist because of all the heart palpitations. Yup, it was the scrip and I went back to my saline solution,
The Doctor still cashed in for the scrip and as it stood, so did the cardiologist.

Ring up number 2.
So, I knew that the Doctor said that I’d have to do another CT scan to see if there’s any growth but instead, I get a call from his office for a pulmonary function test. Huh? Says I.
On Monday, I called his office and spoke to whomever it was I spoke to and told her I was to get a CT scan so somebody is putting the cart before the horse.
I told her that I absolutely know HOW and HOW MUCH I am breathing but I just wanted to know for “How Much” LONGER I was going to BE breathing.
She said they’d get back to me within 24-36 hours but meanwhile, for two days they called me wanting a reply about making my appointment for the Function test. NO says I. Twice. You can’t ring the cash register if I’m not going to even make a reservation. Says I.

Finally, They called me on Wednesday and set an appointment for a Contrast CT scan on Friday afternoon and followed it up by telling me that I can’t have any caffeine before the scan. HUH? NO CAFFEINE and my appointment isn’t until 1545? (3:45 PM)

To wit, I know they’re taking out some revenge on me by denying me coffee for not letting them ring up that function test. Dr. Google says the function test runs about 1,200 + dollars for about 30 minutes worth of time. Technological prostitution says I and the only one normally enjoying it is the doctor but not THIS time !!!
Click to expand...
I have had a nodule or two for many years. I am a non-smoker, so it is probably due to something I was exposed to during my long life. They always find, always order a follow-up to see if there is any change and there never is any. I have a spot on my retina that is the same way.
 
Bobby Cole said:
I guess I have something that might not be so much about fraud as it is about a physician trying to ring up the cash register for something unnessary.

Long story short, I had an CT scan without contrast about 2 months ago and they found a 7mm nodule on my upper left lung. Beh, says I. The size of a pencil eraser.
Anyway, my insurance company wanted me to schedule with a pulmonologist, which I did. He told me that the nodules are known to go away, stay the same or grow but all that said, he’d schedule me for another scan in a couple of months just to see what it’s going to do.

Now for the first cash register ringing.
The good doctor asked me about any phlegm buildup and I said yup, all my life but I’m getting rid of a lot of it by using my nebulizer w/ a small dose of saline solution. Note: it works extremely well.
The doc then gave me “that look” and said he’d rather I did something different for my nebulizer and gave me a scrip that two weeks later, had me going to my cardiologist because of all the heart palpitations. Yup, it was the scrip and I went back to my saline solution,
The Doctor still cashed in for the scrip and as it stood, so did the cardiologist.

Ring up number 2.
So, I knew that the Doctor said that I’d have to do another CT scan to see if there’s any growth but instead, I get a call from his office for a pulmonary function test. Huh? Says I.
On Monday, I called his office and spoke to whomever it was I spoke to and told her I was to get a CT scan so somebody is putting the cart before the horse.
I told her that I absolutely know HOW and HOW MUCH I am breathing but I just wanted to know for “How Much” LONGER I was going to BE breathing.
She said they’d get back to me within 24-36 hours but meanwhile, for two days they called me wanting a reply about making my appointment for the Function test. NO says I. Twice. You can’t ring the cash register if I’m not going to even make a reservation. Says I.

Finally, They called me on Wednesday and set an appointment for a Contrast CT scan on Friday afternoon and followed it up by telling me that I can’t have any caffeine before the scan. HUH? NO CAFFEINE and my appointment isn’t until 1545? (3:45 PM)

To wit, I know they’re taking out some revenge on me by denying me coffee for not letting them ring up that function test. Dr. Google says the function test runs about 1,200 + dollars for about 30 minutes worth of time. Technological prostitution says I and the only one normally enjoying it is the doctor but not THIS time !!!
Click to expand...
If you have been hospitalized, note how often they want to take blood - every couple of hours. Also note that immediately after each blood draw, the nurse goes to the computer & enters it.....caching, caching.....hear that cash register ring....... Also tests & more tests that often have nothing to do with why you're there. Each test is a bill to medicare or whomever your provider is, so you'll get many tests & procedures under the guise of "Complete Care."

Recently, I was in the ER because of sudden blurred vision in one eye. Naturally I wanted it checked since I'm diabetic. After two days, numerous tests, 6 blood draws, & one doctor sticking his head in the room & saying "You had a stroke," then disappearing, then another doctor came in & did some arm & leg strength tests & said, "No way you had a stroke; you're stronger than I am." No reason given for my blurred vision. They wanted me to stay longer for more tests. I said, "No thanks; Had enough; goodbye."
I did some research & found the cause: The prostate medication the urologist gave me; two of the common side effects are blurred vision & low blood pressure when standing (known as "Orthostatic Hypotension") due to the fact that these drugs are Alpha Blockers. You would think a doctor would notify a patient to watch for dangerous side effects when prescribing a drug..........
I reduced the dosage on my own, problems disappeared.
 
@Bobby Cole - at our ages and time left is what I base the next medical step on.
If the out come of the findings, can include you will live better now versus just another 20 years - then maybe you feel justified spending that money. It just depends on what you want and feel is necessary to live your life.
If you were say 50 and under , um might consider the better outcome.
My point being is, doctors are suppose to everything they can to make us live longer. My goal in life is merely to live well while I am still here, I care nothing about living forever.
As for trust, that is still a big question in today's medical field.
 
Hedi Mitchell said:
When my mother was in hospital 20 plus years ago, she had a major stroke,and was kept alive til I could get there.
A nurse came in to take blood, and my brother stopped her and said No. Why do you need more blood from a dying woman /
That summed it up for me,
Click to expand...
My mother was bedridden for the last two months of her life. We were told she had numerous blood clots around her heart & lungs & she has a couple of weeks left. A nurse came in several times/day to take blood; often an incompetent one who caused a lot of pain. I asked one nurse why it was necessary to keep taking blood every few hours. (I didn't know the real reason back then). She said, "It's required because she's on blood thinners." Then one day while I was there, an especially incompetent nurse started to take blood & repeatedly kept poking & poking while my mother screamed in pain. I stood up & said calmly to her, "Just get out." Then I spoke to the head nurse & said, "Keep that idiot out of her room & no more blood draws; they're unnecessary."
The next day, the hospital called me & said, "You can take her home now; she's better."
I suspected I was being lied to. I said, "Is she walking?"
"Yes."
I asked, "When did she last walk?"
"Wednesday."
I asked, "Yesterday?"
"Uh....."Wednesday three weeks ago."

I contacted the Director of nursing & they allowed another week, when she passed.

That's known as "Patient Dumping." It happens when hospitals realize they're not going to make any more money from a patient.
 
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Hedi Mitchell said:
@Bobby Cole - at our ages and time left is what I base the next medical step on.
If the out come of the findings, can include you will live better now versus just another 20 years - then maybe you feel justified spending that money. It just depends on what you want and feel is necessary to live your life.
If you were say 50 and under , um might consider the better outcome.
My point being is, doctors are suppose to everything they can to make us live longer. My goal in life is merely to live well while I am still here, I care nothing about living forever.
As for trust, that is still a big question in today's medical field.
Click to expand...
To be totally honest, the only reason I went to get the secondary scan today is out of curiosity.
If the nodule has grown, I’m not going to spend a major portion that is left of what life I have left in hospitals and doctor’s offices being subjected to what I call, experimental procedures and near butchery that to me, lessen quality of life and costs a ton of money.
I have had a full 76 years of life so far and when it’s time to go home, I’ll go with only one regret which is leaving my wife, Yvonne.

Note: I was told by the nurse or receptionist yesterday that I could have NO caffeine today due to the type of the CT scan I was scheduled to recieve.
I COULD HAVE HAD 10 pots of coffee if I had wanted to because all I had was a plain old “shove ‘im in the tube and listen to it whirrrrrr” CT.
I’m gonna find out what the scan indicated and get rid of the pulmonary hack, staff and phone number,
That so called “doctor” is a prime reason the medical industry calls his game of ill gotten gains a “practice”.

Deny me my McCafe’ full of luscious caffeine for no reason?
No more Ca-Ching in the register from this gentleman’s insurance policy or pocket !!!
 
Bobby Cole said:
To be totally honest, the only reason I went to get the secondary scan today is out of curiosity.
If the nodule has grown, I’m not going to spend a major portion that is left of what life I have left in hospitals and doctor’s offices being subjected to what I call, experimental procedures and near butchery that to me, lessen quality of life and costs a ton of money.
I have had a full 76 years of life so far and when it’s time to go home, I’ll go with only one regret which is leaving my wife, Yvonne.

Note: I was told by the nurse or receptionist yesterday that I could have NO caffeine today due to the type of the CT scan I was scheduled to recieve.
I COULD HAVE HAD 10 pots of coffee if I had wanted to because all I had was a plain old “shove ‘im in the tube and listen to it whirrrrrr” CT.
I’m gonna find out what the scan indicated and get rid of the pulmonary hack, staff and phone number,
That so called “doctor” is a prime reason the medical industry calls his game of ill gotten gains a “practice”.

Deny me my McCafe’ full of luscious caffeine for no reason?
No more Ca-Ching in the register from this gentleman’s insurance policy or pocket !!!
Click to expand...

:coffee::giggle:
 
Bobby Cole said:
Asked a couple of dentists how much a procedure will cost and both of them denied knowing and told me to ask at the reception desk.

Every single working person knows how much a job is going to make him or her or how much per hour they’re working for and no one can tell me that a doctor is any different.
Click to expand...
I am with you 100% but my GP took out the mouth of a tick from my leg when I had company insurance with a $1000 deductible. The cost for digging out mouth parts was $900!!!! I would have dug it our with my Swiss army knife if I had known. His nurse later asked me why I fight coming in for check ups etc when I was in for a self scheduled tetanus shot. I said, no I growled, that the Dr had charged me $900 for taking a tick head out of my leg!!!
The Dr ( apparently afraid to ask me himself) stuck his head in and said he is not in charge of the billing. The clinics around me and the hospital have all been taken over by corporations. I said I want to know charges in advance.
Pretty sure that's not gonna happen.
 
Tony Nathanson said:
My mother was bedridden for the last two months of her life. We were told she had numerous blood clots around her heart & lungs & she has a couple of weeks left. A nurse came in several times/day to take blood; often an incompetent one who caused a lot of pain. I asked one nurse why it was necessary to keep taking blood every few hours. (I didn't know the real reason back then). She said, "It's required because she's on blood thinners." Then one day while I was there, an especially incompetent nurse started to take blood & repeatedly kept poking & poking while my mother screamed in pain. I stood up & said calmly to her, "Just get out." Then I spoke to the head nurse & said, "Keep that idiot out of her room & no more blood draws; they're unnecessary."
The next day, the hospital called me & said, "You can take her home now; she's better."
I suspected I was being lied to. I said, "Is she walking?"
"Yes."
I asked, "When did she last walk?"
"Wednesday."
I asked, "Yesterday?"
"Uh....."Wednesday three weeks ago."

I contacted the Director of nursing & they allowed another week, when she passed.

That's known as "Patient Dumping." It happens when hospitals realize they're not going to make any more money from a patient.
Click to expand...
That's beyond infuriating.
 
Mary Stetler said:
I am with you 100% but my GP took out the mouth of a tick from my leg when I had company insurance with a $1000 deductible. The cost for digging out mouth parts was $900!!!! I would have dug it our with my Swiss army knife if I had known. His nurse later asked me why I fight coming in for check ups etc when I was in for a self scheduled tetanus shot. I said, no I growled, that the Dr had charged me $900 for taking a tick head out of my leg!!!
The Dr ( apparently afraid to ask me himself) stuck his head in and said he is not in charge of the billing. The clinics around me and the hospital have all been taken over by corporations. I said I want to know charges in advance.
Pretty sure that's not gonna happen.
Click to expand...
A friend was going to school to learn "Medical Billing." I asked her why it took so long. She explained that medical billing is in code so patients can't read it or understand it. Pretty good reason for that.
 
Mary Stetler said:
I am with you 100% but my GP took out the mouth of a tick from my leg when I had company insurance with a $1000 deductible. The cost for digging out mouth parts was $900!!!! I would have dug it our with my Swiss army knife if I had known. His nurse later asked me why I fight coming in for check ups etc when I was in for a self scheduled tetanus shot. I said, no I growled, that the Dr had charged me $900 for taking a tick head out of my leg!!!
The Dr ( apparently afraid to ask me himself) stuck his head in and said he is not in charge of the billing. The clinics around me and the hospital have all been taken over by corporations. I said I want to know charges in advance.
Pretty sure that's not gonna happen.
Click to expand...
I don’t remember how many years ago it happened but in the vast industry of auto repair, Congress passed an edict that said that auto repair shops Had to give an estimate of the work to be performed and the actual cost of the job couldn’t exceed a small percentage (I can’t remember what the % was) and any work performed that wasn’t in the initial estimate couldn’t be charged for.
Moreover, if the mechanic didn’t repair the auto, the shop couldn’t charge anything at all.

Seems to me that the same laws should apply to all things including in the medical field. If, in a consultation the doctor says that the gall bladder has to come out then the patient should be free to shop around for the best price w/ good quality work before anyone pulls out the cutlery.

Now, just to backtrack a bit, if I remember right, D. Trump said at some point that clinics, hospitals and Dr.’s offices should have something like a “menu” that states how much a procedure and medications cost before a patient agrees to be worked on.
The way it is now, we sign a piece of paper that says who will pay for the procedure (no matter how much it costs) or office visit. To me, that’s a grand opportunity for insurance fraud, lies and a misrepresentation of facts.

SURPRISE !! Your office visit was $450 for 5 minutes of the Doctor’s time. Would you like a scrip for the newly squires anxiety attack?
 
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