The Do Not Pay list will include more than just healthcare, but the huge area here is Social Security.  Fraud is a big case on everyone’s list and needs both technical and non imagetechnical support to enforce.  A while back I wrote about the crooks being better billers, why, they don’t see patients and have one focus only – fraud.  The link below has a couple of videos and additional information that support this and how some of these folks get by with this stuff.  

Medicare Fraud – Criminals Do a Better Job With Filing Claims And Coding Than Providers

One area that hit the government in the face too was not connecting NPI numbers of deceased doctors, and there’s also billing done for dead patients too, but the NPI number should have been cross referenced a long time ago but now with infrastructure updates that is going to happen.  There were multitudes of claims paid with NPI numbers from deceased doctors. 

Probe finds dead doctors used in Medicare Scam

This video is from a short while back from 60 Minutes and he talks about he went about his acts of fraud and how easy it was for him, well until he was caught. 


In the world of data and otherwise we almost have to anticipate and try out best to stay one step ahead of the deviate minds on the criminal side and if we don’t, well this post pretty much says all.  BD 

Before agencies issue payments, they must cross-check federal databases of people who have died, and of individuals and companies that have been suspended from doing business with the federal government or are otherwise ineligible to receive federal funds, President Obama ordered Friday.

Over the past three years, agencies have paid out $180 million in benefits to 20,000 Americans who are dead and more than $230 million to about 14,000 fugitives or incarcerated felons who are ineligible for payments, Vice President Biden said at a news briefing.

Obama's memorandum orders agencies to cross-check the Social Security Administration's master file of deceased individuals, the General Services Administration's list of suspended or debarred contractors, the Treasury Department's list of people who owe the government money, the Health and Human Services Department's list of individuals and businesses excluded from participating in federal health care programs, and the Housing and Urban Development Department's credit alert systems for flagging people ineligible for federal loans.

The administration plans to consolidate all of those databases into a single "Do Not Pay" list to make it easier for agencies to check the status of individuals and businesses before issuing federal payments. Officials did not say when the Do Not Pay list will be established.

Administration announces 'Do Not Pay' list - FederalTimes.com

2 comments :

  1. Wow,nice, one of the best read posts so far.

    ReplyDelete
  2. While eliminating payments to dead physicians should save Medicare money, it won't do anything to improve quality of care

    ReplyDelete

 
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