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July 30, 2016, 4:25 pm

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We hear so much about health care fraud and how much it costs us all in terms of higher Medicaid, betagan 5ml eye drops bottle $33.00 Medicare and private insurance costs, betagan 5ml eye drops bottle $33.00 and if we could just rein in this fraud we could make our health care system pay for itself.

My trusty Mac widget dictionary defines fraud as:

  • a person or thing intended to deceive others, betagan 5ml eye drops bottle $33.00 typically by unjustifiably claiming or being credited with accomplishments or qualities and
  • wrongful or criminal deception intended to result in financial or personal gain.

Well, betagan 5ml eye drops bottle $33.00 I’m wondering, betagan 5ml eye drops bottle $33.00 what is actually considered fraud?

Let me give some examples, betagan 5ml eye drops bottle $33.00 and help me understand whether or not this is fraudulent behavior. Betagan 5ml eye drops bottle $33.00 The examples are purely hypothetical and do not represent any known individuals, betagan 5ml eye drops bottle $33.00 living or dead, betagan 5ml eye drops bottle $33.00 or specific situations in any known emergency department, betagan 5ml eye drops bottle $33.00 living or dead.

  • A patient covered under Medicaid utilizes the emergency medical system by calling 911 for transport to an emergency department to obtain a refill for a non-emergent medication (ie, betagan 5ml eye drops bottle $33.00 not insulin).

Betagan 5ml eye drops bottle $33.00 Fraud? If the patient does not claim an emergency problem, betagan 5ml eye drops bottle $33.00 there is no deception, betagan 5ml eye drops bottle $33.00 ergo no fraud. Betagan 5ml eye drops bottle $33.00 But if the Medics can’t triage this call out (aka, betagan 5ml eye drops bottle $33.00 say “HELL, betagan 5ml eye drops bottle $33.00 no!”), betagan 5ml eye drops bottle $33.00 there is a $1000 ambulance bill and it’s at least $1000 to walk in the ER. Betagan 5ml eye drops bottle $33.00 The patient pays nothing. Betagan 5ml eye drops bottle $33.00 If this isn’t a fraudulent use of the EMS system, betagan 5ml eye drops bottle $33.00 what do we call it, betagan 5ml eye drops bottle $33.00 abuse? Abuse for personal gain?

  • A parent walks in to the emergency department with his eight children, betagan 5ml eye drops bottle $33.00 all of whom are covered by Medicaid. Betagan 5ml eye drops bottle $33.00 He wants all eight children seen for colds. Betagan 5ml eye drops bottle $33.00 It is the middle of the day. Betagan 5ml eye drops bottle $33.00 The local pediatric clinic is open. Betagan 5ml eye drops bottle $33.00 It is ascertained that the clinic will see all the children later in the day. Betagan 5ml eye drops bottle $33.00 It is also ascertained that the father is aware that the cost of seeing the eight children will be one hundred times higher in the emergency department than in the clinic. Betagan 5ml eye drops bottle $33.00 The response is “I don’t care. Betagan 5ml eye drops bottle $33.00 I’m not paying for it.”

Betagan 5ml eye drops bottle $33.00 Fraud? Again, betagan 5ml eye drops bottle $33.00 no claim of an emergent problem, betagan 5ml eye drops bottle $33.00 so no fraud by definition. Betagan 5ml eye drops bottle $33.00 But the ED cannot, betagan 5ml eye drops bottle $33.00 by law, betagan 5ml eye drops bottle $33.00 turn the father and the children away, betagan 5ml eye drops bottle $33.00 at least here in CA. Betagan 5ml eye drops bottle $33.00 So, betagan 5ml eye drops bottle $33.00 if the cost of a clinic visit is $20 (for example) and the total visit for each child in the ED is $2000, betagan 5ml eye drops bottle $33.00 that’s quite a bill that Medicaid now has to deal with. Betagan 5ml eye drops bottle $33.00 Again, betagan 5ml eye drops bottle $33.00 if it’s not fraud, betagan 5ml eye drops bottle $33.00 do we call it abuse for personal gain?

  • A patient covered by Medicaid utilizes the EMS system for transport, betagan 5ml eye drops bottle $33.00 requesting a hospital quite a distance from where they live. Betagan 5ml eye drops bottle $33.00 The chief complaint given the paramedics is not the same complaint they state on arrival. Betagan 5ml eye drops bottle $33.00 The revised complaint would have required the medics to take them to the closest hospital. Betagan 5ml eye drops bottle $33.00 This is the fifteenth visit in four weeks. Betagan 5ml eye drops bottle $33.00 All by ambulance. Betagan 5ml eye drops bottle $33.00 Given the patient’s history and the chief complaint on arrival, betagan 5ml eye drops bottle $33.00 most ED docs feel obligated to at least a minimal work-up. Betagan 5ml eye drops bottle $33.00 Multiple doses of narcotics are required. Betagan 5ml eye drops bottle $33.00 Lots of narcotics. Betagan 5ml eye drops bottle $33.00 Gallons of narcotics. Betagan 5ml eye drops bottle $33.00 Hour are spent. Betagan 5ml eye drops bottle $33.00 Disposition is always discharge.

Betagan 5ml eye drops bottle $33.00 Fraud? I’m calling yes on this one. Betagan 5ml eye drops bottle $33.00 Patient wants a specific facility, betagan 5ml eye drops bottle $33.00 knows how to get there by not using an emergent symptom until arrival – that is deception, betagan 5ml eye drops bottle $33.00 at least. Betagan 5ml eye drops bottle $33.00 It’s drug seeking, betagan 5ml eye drops bottle $33.00 and drug seeking is fraud, betagan 5ml eye drops bottle $33.00 hands down. Betagan 5ml eye drops bottle $33.00 But how do you prove it? In this example, betagan 5ml eye drops bottle $33.00 the patient is racking up tens of thousands of dollars in medical bills on a weekly basis. Betagan 5ml eye drops bottle $33.00 The medics can’t refuse to transport the patient, betagan 5ml eye drops bottle $33.00 the facility can’t refuse to see the patient (although slowing down on the narcotics might slow down on the visits, betagan 5ml eye drops bottle $33.00 no?) It’s deception for personal gain – so a fraud vote for me.

  • Patient needs a procedure. Betagan 5ml eye drops bottle $33.00 It is not emergent. Betagan 5ml eye drops bottle $33.00 Patient is not dying. Betagan 5ml eye drops bottle $33.00 Patient is perfectly fine and stable pre-op. Betagan 5ml eye drops bottle $33.00 Procedure is actually scheduled. Betagan 5ml eye drops bottle $33.00 But in order for the private insurance company to cover the procedure, betagan 5ml eye drops bottle $33.00 the patient must be admitted through the emergency department, betagan 5ml eye drops bottle $33.00 and actually go to the procedure from the ED. Betagan 5ml eye drops bottle $33.00 So, betagan 5ml eye drops bottle $33.00 a full triage is done. Betagan 5ml eye drops bottle $33.00 An IV is inserted. Betagan 5ml eye drops bottle $33.00 An ED charge goes on the books.

Betagan 5ml eye drops bottle $33.00 Fraud? Oh hell, betagan 5ml eye drops bottle $33.00 yes. Betagan 5ml eye drops bottle $33.00 Would someone explain to me why this is not fraud? If you need a procedure, betagan 5ml eye drops bottle $33.00 you go the normal route like everyone else. Betagan 5ml eye drops bottle $33.00 This pretending you had to come into the ED first is a bunch of bull***. Betagan 5ml eye drops bottle $33.00 Good thing I never see it (cough) because I sure as hell would have nothing to do with it.

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Now that I look over these examples, betagan 5ml eye drops bottle $33.00 I see more abuse than I do actual fraud.

Either way, betagan 5ml eye drops bottle $33.00 it is a ton of waste.

How do we stop it?

They don’t let us stop it on site. Betagan 5ml eye drops bottle $33.00 We cannot turn away non-emergencies. Betagan 5ml eye drops bottle $33.00 Medics cannot refuse to transport.

Look at fraud, betagan 5ml eye drops bottle $33.00 yes, betagan 5ml eye drops bottle $33.00 but do something about the abuse of the health care system, betagan 5ml eye drops bottle $33.00 too.

Betagan 5ml eye drops bottle $33.00

There is no penalty for abusing the system.

In fact, betagan 5ml eye drops bottle $33.00 I don’t think people even recognize that they are, betagan 5ml eye drops bottle $33.00 in fact, betagan 5ml eye drops bottle $33.00 abusing the system.

I think they see it as their right to use it as they see fit, betagan 5ml eye drops bottle $33.00 no matter what the cost. Betagan 5ml eye drops bottle $33.00 It’s there to use to their convenience.

And it doesn’t matter if it’s Medicaid, betagan 5ml eye drops bottle $33.00 Medicare or private insurance!

Until people stop seeing their healthcare as being provided for free, betagan 5ml eye drops bottle $33.00 there is no incentive to use it efficiently.

When you don’t have to pay the Piper, betagan 5ml eye drops bottle $33.00 you don’t care what tune he plays.

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July 30, 2016, 5:07 pm

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About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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