JANUARY 12, 2011
A year after a congressional audit exposed exorbitant fraud and abuse in the federal government’s insurance program for the poor, the Justice Department is suing New York City for cheating it out of tens of millions of dollars in the last decade.Corruption in the Medicaid program is nothing new but the complaint, filed this week by the U.S. Attorney in Manhattan, indicates the problem is much worst than previously reported. Federal authorities claim that nearly 18,000 people in the city received costly, taxpayer-financed personal care services that should not have been covered or weren’t medically necessary.The government was billed between $75,000 to $150,000 a year for the special services that include 24-hour aides that help with housecleaning, shopping, bathing and other personal needs. The city routinely reauthorized the care without obtaining the required assessment from a physician, according to the lawsuit which was filed after a whistleblower complaint. In some cases, the city actually overruled medical professionals and social workers to grant the benefit.About a year ago a congressional report included New York as one of five states with the highest rate of Medicaid fraud. During a two-year investigation, 65,000 instances of prescription fraud cost U.S. taxpayers about $65 million in the top five states alone. An additional $2.3 million went to practitioners and pharmacies banned from federal health care programs, nearly 2,000 prescriptions were written for dead patients and 1,200 prescriptions were written by dead doctors.New York’s Medicaid system is the largest and most expensive (around $48 billion annually) in the nation because it extends benefits to the middle class and allows excessive use of certain costly services that aren’t always related to medical care. It’s also rife with fraud and corruption orchestrated by unscrupulous practitioners who have cheated the system out of billions of dollars over the years.A growing number of New York practitioners and companies that have fraudulently received hundreds of millions of dollars from Medicaid have been indicted for corruption in the last few years. Among them is a dentist who bilked the system out of more than $1 million, a company that got $200 annually to transport patients and another that got $1 billion to give poor students questionable speech therapy.Additionally, the state’s Medicaid program has been cheated by several criminal rings that duped it into paying tens of millions of dollars to give bodybuilders a costly muscle-building drug intended for AIDS patients and to provide Viagra for hundreds of sex offenders. Some may wonder what took the feds so long to take action.
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