Key to stop­ping fraud is re­quir­ing per­sonal re­spon­si­bil­ity

Modern Healthcare - - COMMENT -

Re­gard­ing the ar­ti­cle “Former Tuomey CEO to per­son­ally pay $1 mil­lion to settle False Claims Act case” (ModernHealth­, Sept. 27), the key to stop­ping fla­grant Medi­care fraud is to ab­so­lutely make the per­pe­tra­tors di­rectly and per­son­ally re­spon­si­ble on a crim­i­nal and fi­nan­cial ba­sis. When enough of these cases are han­dled in such a man­ner, their peers will quickly un­der­stand there is no re­ward or sta­tus for gam­ing Medi­care reg­u­la­tions.

An­other log­i­cal step to put the brakes on the most rapidly grow­ing, lu­cra­tive busi­ness in health­care— Medi­care fraud—is to hold the physi­cians mak­ing re­fer­rals to spe­cial­ists and other ser­vices re­spon­si­ble for en­sur­ing they are in no way com­plicit in sup­port­ing acts of Medi­care fraud, e.g., on­col­o­gists or­der­ing un­nec­es­sary PET scans, treat­ing pa­tients with EPO drugs, etc.

With our tax dol­lars now pay­ing for over 50% of health­care these days (Medi­care/Med­i­caid/VA) stricter en­force­ment, with se­vere per­sonal penal­ties, as was dealt this ex-CEO, is the only medicine to cure those so com­mit­ted to ig­nor­ing Medi­care reg­u­la­tions for their ben­e­fit.

M.E. Singer


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