Tuesday, December 8, 2015

False Claim

In the histrionics about Voter Fraud the reality is that it is non starter. There is little conclusive evidence that it occurs and the affect is what exactly? Someone voted and that one of one percent turned the election on its head? Really it did.
When you hear the boring repetitive rhetoric about safety nets, welfare queens and the need to end "entitlement" programs maybe they need to change that conversation to include the tax breaks to the wealthy with their bizarre foundations/LLC and Museums, the endless corporate tax breaks that enable a business fined by the Government for whatever malfesance they committed to take a deduction for that same fee and the real robber barons - the medical industrial complex - that puts the defense one to shame when it comes to fraud and corruption.
I would like to file a claim that this is the problem with the skyrocketing costs of care - from the costs of drugs to hospitalizations.  The pie is only so big and the pieces getting cut leave little for the baker - the American taxpayer. 

Health care fraud tops lists of False Claims Act violations
U.S. recovers $1.9 billion in bogus charges from hospitals, drug firms, other providers

By John Russell
 Chicago Tribune
December 8 2015
   Health care fraud topped the list of federal crackdowns this year under the False Claims Act, accounting for more than half of $3.5 billion in settlements and judgments.    

 The federal government recovered $1.9 billion to settle claims against companies and people charged with providing unnecessary or inadequate care, paying kickbacks to health care providers, or overcharging for goods and services paid for by Medicare, Medicaid and other federal health care programs. The settlements were for the fiscal year that ended Sept. 30.    

 Hospitals were involved in nearly $330 million of settlements and judgments, led by a massive settlement by 457 hospitals in 43 states related to cardiac devices that were implanted in Medicare patients in violation of Medicare billing rules. That included eight hospitals affiliated with Advocate Health and Hospitals, based in Downers Grove; and Memorial Health System and Memorial Medical Center, of Springfield.    

 The nation’s second-largest nursing home pharmacy, PharMerica Corp. of Louisville, Ky., paid $9.25 million to resolve allegations that it solicited and received kickbacks from Abbott Laboratories of North Chicago in exchange for promoting the anti-seizure medicine Depakote for patients. 

In 2012, Abbott resolved related claims by agreeing to pay $1.5 billion that it promoted Depakote for unapproved uses in numerous nursing homes around the country.    

 Claims involving pharmaceutical companies accounted for $96 million in settlements and judgments. Japanese drugmaker Daiichi Sankyo, with U.S. headquarters in New Jersey, resolved claims that it paid kickbacks to physicians to induce them to prescribe certain drugs for high blood pressure and cholesterol. AstraZeneca LP and Cephalon Inc. paid $26.7 million and $4.3 million, respectively, to settle claims they underpaid rebates owed under the Medicaid Drug Rebate Program.     

Two of the largest recoveries were from Denver-based DaVita Healthcare Partners Inc., which operates a chain of dialysis clinics. DaVita paid $450 million to resolve allegations that it knowingly generated unnecessary waste in administering drugs to dialysis patients and then billed the government for costs that could have been avoided. DaVita paid an additional $350 million to resolve claims that it paid kickbacks to physicians for referrals.     

The government calls the False Claims Act its primary civil remedy for fraud and false claims. In addition to health care fraud, the federal government recovered money this year related to housing and mortgage fraud, government contracts, federal crop insurance, federal student aid and small business loans

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