Jan 16, 2013

Fraudulent Charges

"For-profit nursing homes are more likely to overbill taxpayers for treatments patients do not need or never receive " U. S. federal health inspector's November report

Fraudulent charges are something we, as caregivers, are smart to watch for -- whether it is for a medical visit or some other service.  Recently, I noticed that Medicare was being billed for 45 minutes of PT (physical therapy) each time Dwane went, but I noticed that the therapist stopped at 30 minutes.  Since noticing the discrepancy, I have made a point in stating beforehand:  "This is for 45 minutes, right?' -- and the therapist has worked with Dwane the full 45 minutes. The above-mentioned study found that 30% of claims submitted by for-profit nursing homes were improper, compared with 12% for nonprofit.  In the U.S. investors own 3/4 of the $105 billion nursing-home market and typically earn a 20% profit margin on Medicare, compared with a 9% profit for nonprofit nursing homes.  It costs all of us if we allow fraudulent charges.  It is a good idea for us to check to make sure our care receivers are being charged for only what is appropriate.

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