Tag: medicare fraud
Rick Scott

The Sordid History Behind Rick Scott's Medicare Mess

In Washington, acrimonious public disagreements among congressional leaders of the same party are unusual, which was why reporters took note not long ago when Sen. Mitch McConnell publicly spanked Sen. Rick Scott for what he considered an act of monumental stupidity.

What infuriated the Senate minority leader, who yearns above all to become the majority leader again, was Scott's unveiling of a 60-page "plan" describing what the Republicans will do if and when their party regains the majority. As chair of the National Republican Senatorial Committee, Scott's job is to ensure victory in the November midterm by doling out tens of millions to candidates.

But McConnell saw Scott's plan as the equivalent of a loud emission of noxious gas: unpleasant, unhelpful, and very much to be avoided. McConnell has steadfastly refused to state what Republicans would do if they win the Senate; now, the lunkhead Rick Scott has let the cat out of the bag.

Especially irksome to McConnell were two aspects of Scott's blueprint. "Let me tell you what would not be part of our agenda," snapped McConnell. "We will not have, as part of our agenda, a bill that raises taxes on half the American people and sunsets Social Security and Medicare within five years. That will not be part of the Republican Senate majority agenda."

Of course, McConnell just doesn't want to tell voters what his party will do, because their ideas are deeply unpopular and always get them in trouble, like when Newt Gingrich proposed privatizing Medicare and former President George W. Bush proposed privatizing Social Security.

Scott's scheme to raise income taxes on most households struck McConnell as politically insane, and so did the plan's endorsement of allowing "all federal legislation," including Social Security, Medicare and Medicaid, to simply expire within five years.

Scott, for his part, has portrayed himself as a "bold" visionary victimized by conventional thinkers. Polling, however, indicates that the Scott scheme is profoundly unpopular among all voters, including Republicans, with majorities north of 65% rejecting it. No more than 15% like it.

So, the Florida senator has simply lied since then.

"No one that I know of wants to sunset Medicare or Social Security," he insists, although that's exactly what his plan urges.Perhaps McConnell was too polite to mention the other utterly politically crazy aspect of the Scott proposal: namely, the likelihood that attacking Medicare and Medicaid will remind America about the massive health care fraud underlying Rick Scott's enormous personal fortune, estimated at $300 million.

Beginning in 1987, Scott founded and built Columbia/HCA, a hospital chain that included hundreds of health care providers across multiple states and engorged itself on billions in Medicare and Medicaid fees. Unfortunately, this lucrative business involved truly gigantic levels of fraud, which by early 1997 drew the attention of federal investigators. Columbia/HCA illegally scammed billions of dollars intended for patient care, perpetrating what remains the biggest fraud on government ever by any health care institution.

The company's board forced Scott to resign within months after the federal investigation became public. He pleaded ignorance, barely escaped indictment and walked away with vast wealth. He claims to have accepted "responsibility," although he consistently blamed others, adding piously that the experience "made me a better leader."

Somehow, Florida's voters narrowly elected him governor in 2010 and then to the U.S. Senate in 2018. The words of his 2010 primary opponent Bill McCollum, a former Navy prosecutor and Florida attorney general, still ring true. During the campaign McCollum denounced Scott as "the disgraced former CEO of Columbia/HCA who is inseparably associated with one of the most massive Medicare fraud schemes in American history."

Scott's sordid narrative raises an obvious question. How did this come to pass? We know that Florida voters have a habit of electing some truly awful politicians, and that Scott spent $60 million to win his first election. We know that Republican leaders in Washington have no problem with fraud or corruption, so long as it accrues to their own power. Just ask "Moscow Mitch," who was in the tank for Oleg Deripaska, a sanctioned Russian oligarch with Kentucky investments. We know that the Republican concern for ensuring the fairness and stability of our health care system is nil, given their long war against Medicare and, more recently, the Affordable Care Act. Now, they won't even act to reduce the cost of lifesaving insulin.

Voters should be aware that this corporate malefactor is in charge of handing out the big campaign bucks from the Senate Republican campaign — and that he aims to destroy the nation's most successful and popular domestic programs. Somebody better tell them before November. Buyer beware.

To find out more about Joe Conason and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.

First, Do No Harm — To Your Bank Account

First, Do No Harm — To Your Bank Account

After being sued by TheWall Street Journal, the government finally released its Medicare reimbursement data last week. It included the less-than-stunning revelation that 28 of the 100 doctors who received the largest payments in 2012 were from Florida.

No other state came close. And no physician in the country billed Medicare for bigger bucks than Dr. Salomon E. Melgen, a West Palm Beach ophthalmologist who operates several clinics and is tight with a powerful Democratic senator.

Melgen got almost $21 million from Medicare in 2012. (No, you don’t need your vision checked — $20,827,341 is the actual number, for one year.)

Records show Melgen filed claims for 894 patients and 92,000 procedures, meaning Medicare paid him approximately $11,700 for every eyeball that was eyeballed by him and his staff.

Even in Florida, the mecca for Medicare tricksters, Melgen’s billing habits drew notice. The government had already forced him to give back $8.9 million from 2007 and 2008, alleging he overbilled for injectable Lucentis, an expensive medication that combats macular degeneration.

The disorder is common in the elderly, and nationwide the treatment costs Medicare $1 billion a year. In 2012, Melgen reported administering more than 37,000 doses of Lucentis in South Florida.

Currently he’s under investigation for possible fraud, and twice FBI agents have swarmed his offices in search of evidence. His attorney says he’s done nothing wrong, and has taken action to recover the nearly $9 million that Melgen repaid the agency in charge of Medicare and Medicaid.

The doctor has an important ally in Senator Robert Menendez, the New Jersey Democrat, who has traveled on Melgen’s private jet and hung out at his posh spread in the Dominican Republican.

When Melgen first got in trouble, Menendez called the U.S. Department of Health and Human Services to defend his pal’s prolific billing. Another time the senator argued in favor of a company owned by Melgen in a dispute over a seaport contract in the Dominican Republic.

For his part, the doctor donated $700,000 to a Democratic political action committee that gave $582,000 to Menendez’s re-election efforts. So far, Melgen’s friendship with Menendez has failed to deflect the FBI’s interest.

Second on the national scoreboard of Medicare’s top billers is Dr. Asad Qamar, an Ocala cardiologist who was paid $18.2 million in 2012. He told the New York Times that his charges are fair, and that the sum is so large partly because he works in an outpatient facility for which the government pays added fees.

Like Melgen, Qamar is an enthusiastic donor to Democrats, including President Obama. He gave more than $100,000 to the Democratic National Committee, and distributed other contributions to congressional candidates in five states, including Florida.

After federal auditors began examining Qamar’s bills, the doctor hired lobbyists to contact more than a dozen U.S. lawmakers, seeking relief from the scrutiny. “The auditors put an astronomical burden on us, in terms of manpower,” he told the Times.

An astronomical burden caused by astronomical billing.

Any physician who rakes in $18 million from Medicare in 12 months deserves special attention, because such a massive volume of medical claims definitely isn’t business as usual.

In fact, according to a Times analysis, only about 2 percent of doctors collected almost 25 percent of the country’s Medicare payouts in 2012. Expanding that graph, just 25 percent of doctors accounted for 75 percent of Medicare’s total spending, which reached $77 billion that year.

It’s hardly a shocker that Florida leads the way. No place in the nation hosts more Medicare fraud prosecutions, a grim distinction.

The good news is that the conviction rate is high; the bad news is that we could quadruple the number of prosecutors, and they’d still be overworked.

Meanwhile, soaring Medicare costs cut deeper and deeper into federal tax revenues. The program is so huge that it practically defies effective auditing, but certainly a much better job of that could be done.

Publicizing the payment database is a start. Some medical practices are more complex than others, and the numbers only tell part of the story for each physician on the list.

However, it’s more than a statistical blip when two doctors collect a total of $39 million, more than hundreds of other practitioners in those same specialties added together.

California, which has twice the population of Florida, had only 10 doctors in the top 100 Medicare billers, compared to our stellar 28.

It’s not that Florida has more sick and elderly people than California, because we don’t. We just happen to attract more opportunists.

(Carl Hiaasen is a columnist for The Miami Herald. Readers may write to him at: 1 Herald Plaza, Miami, Fla., 33132.)

Photo: Michael McCullough via Flickr