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The Sun-Times - Heber Springs, AR
  • Paul Rawlings: Medicare Fraud

  • Many studies indicate Medicare fraud cost taxpayers more than $60 billion dollars a year and some estimates of the fraud are as high as $300 billion a year.
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  • “Raymond Sean Brown a 44 year old doctor from Cleveland, Tennessee is facing fraud charges after federal prosecutors accused him of getting $7.5 million in Medicare reimbursements for more than 17,000 injections he purportedly never gave.”
     
    This recent article in the Arkansas-Democrat Gazette aroused my curiosity about how widespread was Medicare fraud, who was committing the fraud and who had the responsibility for preventing the fraud.
     
    HOW WIDESPREAD IS MEDICARE FRAUD
     
    Many studies indicate Medicare fraud cost taxpayers more than $60 billion dollars a year and some estimates of the fraud are as high as $300 billion a year.
     
    In 2012 Congress authorized Medicare to spend $536 billion to care for 50 million elderly and disabled Americans, 16% of the federal budget, an amount sufficient to attract fraudulent schemes.
     
     
    WHO IS STEALING FROM MEDICARE AND IN WHAT AMOUNTS
     
    The top 10 corporate fraud cases with the amount of false claims, and some of the fines paid are:
     
    Tenet Healthcare--$900,000,000.—*HCA Healthcare-- $731,400.000.—paid over $840 million in criminal fines—Merck--$650,000.000.—*HCA—$631,000,000.—Serono--$567,000,000.--$136.9 million criminal fine—TAP--$559,483,560.--$290 million criminal fine—Schering Plough--$345,000,000— $180 million criminal fine.—Lilly Pharmacy--$438,000,00--$1.4 billion criminal fine—Abbots Labs $400,000,000.--$200 million criminal fines—Fresenius Medical $385,000,000.--$101 million criminal fines
     
    WHO IS RESPONDIBLE FOR PROTECTING MEDICARE
    Article 1 Section 8 of the U.S Constitution and the Constitutional amendments provide Congress shall have the power and authority over financial and budgetary matters and shall consist of 100 Senators and 435 House members. 
     
    The Judiciary Act of 1789 created the Department Of Justice to be headed by the Attorney General who has the responsibility to prosecute all federal crimes such as Medicare fraud.
     
     
     
     
     
     
    TAXPAYER SUPPORT TO COMBAT MEDICARE FRAUD
     
    To perform their jobs taxpayers provide Senators an annual salary of $174,000.00, have an average size staff of 34 at an average annual salary of $116,573.00.  The 435 House members receive an annual salary of $174,000.00 have an average sized staff of 14 at an average annual salary of $97,619.00.
     
    Taxpayers in 2012 provided the Justice Department $27.1 billion for prosecuting Medicare and other federal crimes.
     
     
    WHAT IS THE DEMOCRAT RECORD ON MEDICARE FRAUD
     
    A Democrat controlled Congress with a Democrat President in the White House passed Obamacare which contains stricter penalties for Medicare fraud and better procedures for enforcement and locating Medicare fraud.
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    A Democrat controlled Justice Department appointed by President Obama, a Democrat President led by Attorney General Eric Holder in May 2013 brought fraud charges against 89 doctors, nurses and other licensed medical professionals in 8 cities for $223 million in false Medicare billings.  This was the 6th national Medicare takedown involving 1,500 people being  charged with fraudulent Medicare schemes involving more than $5 billion.
     
     
    WHAT IS THE REPUBLICAN RECORD ON MEDICARE FRAUD
     
    Not a single Republican Congressman voted for Obamacare  with these stricter penalties and better enforcement of Medicare fraud.
     
    The Republican controlled House has voted 42 times to repeal Obamacare at a cost of $1.45 millon per vote according to The Congressional Research Service.  You do the math on the total cost and time.
     
    CONGRESSIONAL OVERALL APPROVAL, INCLUDING MEDICARE FRAUD
    Numerous polls show only 10% of Americans approve of how Congress is performing its duty--9 out of 10 Americans DISAPPROVE  of the job Congress is doing.
     
    The Senate and House have more than 40 Committees and many sub-committees, not one is called “Committee on Medicare Fraud.”
     
    The last Congress (112) conducted more than 50 Committee hearings not one was on “Medicare Fraud.”
     
     
     
     
     
    OTHER INFORMATION OF INTEREST ON MEDICARE FRAUD
    How many of the 535 Congressmen accepted campaign contributions from people or corporations convicted of Medicare fraud?
     
    How many of the 535 Congressmen campaigned on a plan to eliminate or reduce Medicare fraud?
     
    In the 2012 election cycle 1,331 Super PAC’S spent $609,417,654.00 on political candidates and issues but not ONE was formed to reduce “Medicare fraud.”
     
     
    * HCA (Hospital Care of America) is the largest healthcare for-profit operator in the world located at Nashville, Tennessee.  It was founded by Dr. Thomas Frist Sr. and his sons Dr. Thomas Frist Jr and Dr. Bill Frist.  Dr. Bill Frist owned millions of dollars in HCA stock while serving in the U.S. Senate from 1995-2007 and the last 4 years as Republican Senate Majority Leader.  HCA is # 2 and #4 on the list of  top corporate Medicare frauds.  HCA plead guilty to 14 felonies for fraudulent billings, kickbacks and false costs and paid more than $2 billion in reimbursements and criminal fines. Senate Republican Leader  Frist sold all of his stock in HCA July 1, 2005, two weeks before disappointing earnings  were announced, and HCA paid $20 million to shareholders for Senator Frist’s insider trading and accounting fraud.
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    (Paul Rawlings of Heber Springs contributes each week to the editorial pages of The Sun-Times)
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