Texas Health-Care Services Accused by U.S. of $374 Million in Phony Bills

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Texas Health-Care Services Accused by U.S. of $374 Million in Phony Bills - Bloomberg

The suspects were indicted in U.S. District Court in Dallas on charges including health-care fraud, and accused of sending $350 million in bogus bills to Medicare (FFSOMED) and $24 million in fraudulent bills to Medicaid (USBOMDCA).
The Obama administration has said it’s cracking down on those who steal from government health programs for the elderly, poor and disabled. There are no reliable figures for how much government health programs lose to fraud annually. Senator Tom Coburn, an Oklahoma Republican, estimates the Medicare loss from fraud, waste and abuse at $60 billion to $100 billion annually, according to his spokesman, John Hart.
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Texas doctor accused of huge health fraud scheme | Reuters

The Justice Department also sought to seize numerous bank accounts, homes and other property including several vehicles and two sailboats owned by Roy - one of which is named "One Trick Pony," according to court records.
 
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And the government decided that fraud detection isn't a part of the 80% allowable MLR, but instead should be grouped with other "administrative" expenses subject to the 20% limit. Customer Service goes to India. Fraud detection goes nowhere. Brokers GET OUT NOW! Great job, Obama.
 
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