Another day, another fraud story like this. Time to put some basic policing in place for these programs. This type of fraud should be obvious with minimal investigation and stopped before millions of fraudulent payments are made. Feds investigate Medicaid billing, cars of former NC State football player http://www.wral.com/feds-investigat...-of-former-nc-state-football-player/14520661/ Federal investigators are looking closely at the assets of a Raleigh man linked both to the North Carolina State University athletic program and to a company suspected of Medicaid fraud. The links are laid out in a federal warrant in which IRS agents list cars purchased by Eric and Emily Leak as the possible ill-gotten gains of their business, Nature's Reflections. The Leaks, the warrant says, used the mental health counseling company to transfer money to Eric Leak's Hot Shot Sports Management and to purchase cars for their own use and for the use of Hot Shots clients who are professional athletes. NC State sent a disassociation letter to Eric Leak, a wide receiver for the Wolfpack from 1997 to 2000, from campus in November 2011 after he admitted giving money to C.J. Leslie and another State basketball players. The university banned Leak from campus after cars registered to his wife were ticketed twice on campus during the spring of 2013. Leslie's connection to Leak surfaced again in the federal seizure warrant, which details the purchase of a Porsche in the days after Leslie decided to go pro. According to the warrant, Leslie put down a $10,000 payment on a $137,000 Porsche. Less than two weeks later, Nature's Reflections paid the balance for that sports car. That Porsche is now among three cars the feds want as part of the investigation. The warrant places Leslie's car and two others in a complex web of connected companies moving millions of dollars in fraudulent Medicaid reimbursements. The Leaks' Nature's Reflections billed Medicaid for $8.7 million in services between 2012 and 2014, and during one 16-month stretch, it billed more than any agency in the state for intensive in-home counseling, according to the warrant. (My note - this type of fraud should be obvious and easily stopped before amounting to millions). In interviews with Nature's Reflections employees, Medicaid and IRS investigators found "that Eric Leak directed employees to write service notes for services not rendered," the warrant states. Eric Leak told one employee, according to the warrant, "It doesn't matter if you actually see them -- you're not actually helping people." (More at above url)
The Desperate? They billed Medicaid for people who never heard of the company and never wanted the service. "Investigators found some cases where people who had never heard of Nature's Reflections were recorded as having 100 sessions of care. Investigators believe the Leaks paid for client identifying information or listed as patients Medicaid recipients who never got mental health counseling."
What I meant was, we have a fear of falling society, so people cheat. But fair enough, shady businesses are cheating the system, too.
The majority of Medicare and Medicaid fraud involves shady businesses cheating the government, not individuals cheating the system. Just a little bit of screening effort would be required to prevent a vast majority of Medicaid / Medicare fraud. At this point I should mention for the P&R regulars that my work is picking up, after today I may be scarce around P&R for a few weeks. I wish everyone the best in the usual debates, and urge everyone to be civil in their interactions.
Yes, we are just ending the test phase of the previous project cycle - when I have plenty of "idle" time during test runs. And starting the requirements phase of the next project cycle - lots of meetings, Proof of Concept builds, etc.