"An even larger number of patients received unwanted braces sent to their homes. The unwanted products could disqualify them from receiving a brace under Medicare if they need one in the future, prosecutors said."
So Medicare knows this happened and is still willing to disqualify random people from getting braces? Really? I mean, I believe it but still, this is where we are folks.
It's like someone sued for "damaging" someone's credit, rather than just demanding that damaging information not being used. It's like an idiot going to jail for "SWATing" someone but where the SWAT team can still bust down doors and kill based on random tips.
> "The unwanted products could disqualify them from receiving a brace under Medicare if they need one in the future, prosecutors said."
I read an implied "if we hadn't caught the fraudsters" into that sentence.
As in "if we hadn't realized these braces were fraudulent, patients would have been denied braces they needed because they already reached the maximum number of annual braces covered by Medicare."
Everytime they called me I would try to keep the conversation going telling them I had pain, and then explained that I had a pain in the arse from them calling me all the time.
Medicare is notorious for being rife with fraud and waste. This ring is far from the only one.
This includes mom-and-pop doctors who “upcode” certain procedure codes so that they get paid more. There’s obviously very little the govt can do to check or know. That kind of stuff happens all the time. Like I wonder if the govt is even doing basic anomaly detection on claims data to catch these things...if a ring is getting away with $1bil it makes me think no.
Also...there got to be so much opportunity to build a company around selling a DS tool to the government or insurance companies to help detect and stop medical fraud.
[+] [-] joe_the_user|7 years ago|reply
So Medicare knows this happened and is still willing to disqualify random people from getting braces? Really? I mean, I believe it but still, this is where we are folks.
It's like someone sued for "damaging" someone's credit, rather than just demanding that damaging information not being used. It's like an idiot going to jail for "SWATing" someone but where the SWAT team can still bust down doors and kill based on random tips.
[+] [-] slapshot|7 years ago|reply
I read an implied "if we hadn't caught the fraudsters" into that sentence.
As in "if we hadn't realized these braces were fraudulent, patients would have been denied braces they needed because they already reached the maximum number of annual braces covered by Medicare."
[+] [-] r_smart|7 years ago|reply
Or getting the wrong house. Remember kids: Limited Immunity means complete immunity!
[+] [-] bleriot|7 years ago|reply
[+] [-] StreamBright|7 years ago|reply
[+] [-] kcorbitt|7 years ago|reply
[+] [-] techntoke|7 years ago|reply
[+] [-] tlrobinson|7 years ago|reply
Final chance indeed.
[+] [-] imperio59|7 years ago|reply
[+] [-] randomacct3847|7 years ago|reply
This includes mom-and-pop doctors who “upcode” certain procedure codes so that they get paid more. There’s obviously very little the govt can do to check or know. That kind of stuff happens all the time. Like I wonder if the govt is even doing basic anomaly detection on claims data to catch these things...if a ring is getting away with $1bil it makes me think no.
Also...there got to be so much opportunity to build a company around selling a DS tool to the government or insurance companies to help detect and stop medical fraud.
[+] [-] ronnier|7 years ago|reply
[+] [-] simonh|7 years ago|reply
[+] [-] scandinavian|7 years ago|reply