麻豆传媒

The U.S. Justice Department just 聽in the 鈥渓argest single criminal healthcare fraud case ever brought against individuals.鈥� While the case has not gone to trial yet, the numbers are staggering. It is alleged that over $1 billion in Medicare and Medicaid billings were fraudulently charged by just a few co-conspirators 鈥� one of whom owned several skilled nursing and assisted living facilities and two who worked for a local hospital.

It is disheartening to see the purposeful overutilization and advantage taken of the elderly, poor, and mentally disabled in the story. I was especially saddened to read that patients were purposely addicted to drugs so they could continue the billing cycle scam.

“Defendant [Esformes] and his co-conspirators preyed upon his beneficiaries addictions by providing them with narcotics so that the beneficiaries would remain in Esformes Network facilities, allowing the cycle of fraud [to] continue,” prosecutors said in a court filing.

This is a hard reminder that there are unfortunately a number of “bad players” in healthcare and our industry needs to stay vigilant to prevent the fraud and abuse that can arise out of the system.