In what starts out as a headline Sebelius Releases Privacy-Protected Data that could be interpreted as an effort to get rid of fraud and abuse, there is much more of a nefarious intent. Stick with me for the ride as we go down the rabbit hole and understand that this is the final attack on demonizing and destroying physicians and hospitals.
“The data released today afford researchers, policymakers and the public a new window into health care spending and physician practice patterns”
In a move the administration is promoting as providing consumers “unprecedented transparency on the medical services physicians provide and how much they are paid,” Health and Human Services has released new physician-specific data which had formerly been protected under privacy laws, detailing services, procedures, and billing of individual healthcare providers.
Is there fraud and abuse in Medicare reimbursements? You bet there is. But, as posted back January 6, 2011 – Obamacare hires Bounty Hunters to come after Doctors, the intent is to unleash private mercenaries on the healthcare industry,
It has created a new interagency task force called HEAT (Health Care Fraud Prevention and Enforcement Action Team) under which health-care officials will collaborate with the FBI to go after Medicare fraud. In addition, it has expanded to several cities the Medicaid Fraud Strike Force that authorizes FBI and Drug Enforcement Agency agents to jointly analyze Medicare claims data in real time to detect and investigate irregularities by area doctors.
More chillingly, however, the administration is defining Medicare fraud down to include “unnecessary” and “ineffective” care. And to root this out, it plans to make expanded use of private mercenaries—officially called Recovery Audit Contracts—who will be authorized to go to doctors’ offices and rummage through patients’ records, matching them with billing claims to uncover illicit charges. What’s more, Obamacare increases the fine for billing errors from $11,000 per item to $50,000 without the government even having to prove intent to defraud. Full story here at Reason/a>
And how are they going to find this fraud and abuse? The way is to make it almost impossible to figure out how to “code” or bill using the appropriate number.
Medical Service Codes Go From 18,000 to 140,000 September 16, 2011. Check out the post for the absurdity. A more in-depth look at coding can be found at fellow blogger’s post Prolonging The Agony Or Averting Disaster? by McNorman’s Webblog.
“What’s more, Obamacare increases the fine for billing errors from $11,000 per item to $50,000 without the government even having to prove intent to defraud”
If you wonder why so many physicians have threatened to quit their practice, here is the number one reason. Bounty Hunters. Looking for a missing “bullet point” in the documentation or an inaccurate digit in the billing code. Best part, no legal redress of any dispute. Guilty as charged. Here tis:
Medicare’s billing codes are a complicated, convoluted mess and deciphering them can sometimes be more art than science. Both Republicans and Democrats huff and puff against “waste, fraud and abuse” in Medicare. And they have already enacted Stasi-style laws such as the False Claims Act offering nurses, patients and other whistleblowers 15 percent to 30 percent of any money recovered if they report improper billing practices by providers.