Banned from Medicare; Still Billing Medicaid
Yahoo! News has a special report about physicians who have been banned from billing Medicare or some state Medicaid programs because of fraud, but are still billing other states’ Medicaid programs:
A doctor who took kickbacks from a Pennsylvania hospice involved in a multimillion-dollar fraud. An Ohio psychiatrist who billed for treating no-show patients. A Georgia optometrist who claimed he conducted 177 eye exams in one day.
Their transgressions vary. What these doctors have in common is that each was paid by a state Medicaid health insurance program after being kicked out of another state’s Medicaid system or the federal Medicare program.
More broadly, 32 states and the District of Columbia supplied data showing they paid at least $79 million to 269 of the 1,800 providers after their terminations elsewhere. But the data was incomplete. Extrapolating from what could be verified, Medicaid payments to banned providers could easily reach into the hundreds of millions of dollars.
Mind boggling incompetence? Or government business as usual?
Both.
The states should be held liable for not checking the OIG exclusion list which these doctors would have been on and be fined by the federal government (CMS). Providers have to play by those rules, why shouldn’t the government?
Sickening. How much healthcare could we buy with the money wasted on fraud like this?