Health care providers defrauded Medicaid to the tune of $29 million by coordinating with a day care center for mentally ill adults to steal patient information, the Washington Examiner reports.
Abdul Malik Al-Jumail and his daughter Jamella Al-Jumail created a series of fake health companies, and then collaborated closely with Felicar Williams, 51, who ran the day care center. Felicar would steal patient information, the Jumails would file false claims, and then provide kickbacks to Felicar. Many complex procedures for mental health were billed that were simply never provided.
Sometimes the Jumails would even fabricate entire medical records if necessary to gain reimbursement, showing how patients desperately needed treatment, and how their companies provided care. All three individuals involved are now in prison. The actual sentencing, however, hasn’t yet been scheduled. Two others, Mohammed Sadiq and Philandis Thomas, are charged in the indictment and scheduled for trial later this month. Another individual remains on the loose.
A 61-year-old psychiatrist, Carey Vigor, was also named in the indictment, but was later acquitted by the jury.
As the investigation by the Department of Health and Human Services inspector general (HHS-OIG) deepened and Malik Al-Jumail was promptly arrested, his daughter panicked and instructed an employee to burn the falsified medical records. In total, they siphoned off $29 million dollars in the scam.
However, since its inception in 2007, the HHS-OIG has worked closely with the Department of Justice and the FBI, among others. These agencies together work in the Medicare Fraud Task Force, and together, they have recuperated approximately $14.9 billion dollars. The task force has charged almost 2,000 individuals and operates in 9 cities across the United States.
With this recent case in mind, the HHS Centers for Medicare and Medicaid Services are joining with the HHS-OIG to further crackdown on fraud.
A Michigan branch of the powerful Service Employees International Union saw its membership and revenues plummet after the reversal of a measure that forced caregivers tending to friends or relatives to be members with their dues paid by those they cared for.
More than 44,000 home-based healthcare workers parted ways with SEIU Healthcare Michigan after learning they did not have to join the union or pay dues, according to reports the union filed with the U.S. Department of Labor. Thousands of the employees were allegedly forced into the union under a plan the SEIU successfully lobbied for that classified even unpaid family members caring for their elderly parents as “home health care workers.” Dues were then automatically collected from the care recipients’ Medicare or Medicaid checks.
“Family members were told they were public employees,” Patrick Wright, director of the Mackinac Center Legal Foundation, a Michigan-based policy group, told FoxNews.com. “They are not public employees and this was not proper.
“It was an underhanded scheme to get these people in [the union],” he added.
The measure, which counted the home healthcare recipient as an employer and the caregiver as an employee, was adopted during the administration of Demcratic Gov. Jennifer Granholm, but abolished by Republicans including current Gov. Rick Snyder, who was elected in 2012. His election coincided with the state’s vote to end forced unionization by approving a right-to-work ballot measure. Snyder subsequently signed a bill that ended the SEIU’s due collection scheme.
Wright’s organization estimates that the SEIU reaped nearly $35 million from Michigan’s elderly and disabled from 2006 to last year. Of some 59,000 residents classified as home-based caregivers, about 80 percent stopped paying when they learned they did not have to.
“What the numbers show is that these people never wanted to be in the union in the first place,” Wright said.
Requests for comment to SEIU Healthcare Michigan were not immediately returned.
Some of those charged under the prior scheme are suing to get their money back.
Retired Detroit police officer Robert Haynes and his wife Patricia say they were forced into the union after they were considered public employees because they cared for two adult children with cerebral palsy in their home.
“Our children’s case worker had come for their usual six-month visit and he had told us that we were now part of the union,” Haynes told FoxNews.com. “I was like, ‘What?’”
But Haynes and her husband weren’t concerned.
“I didn’t think much about it,” she said. “Then my husband heard the news that the law was reversed and we realized they were doing nothing for us.”
Haynes said that every month, $30 was deducted from their children’s Medicare payments, and, while it did not break their bank, they objected on principle.
“They couldn’t get me a raise, they couldn’t get me more vacation time and they certainly did nothing to improve my children’s care,” she said. “I’d hate to say it, but in my opinion, they were stealing.”
Haynes also says that they are also hoping to help others who had to pay dues.
“We are not anti-union. I just don’t understand why we were forced to join because I have two disabled kids,” she said. “That we were told that we had to join a union just because we chose to keep our kids at home to care for them.”
WHAT WERE DEMOCRATS THINKING? Why were they so determined to push this on the American people?
Barack Obama repeatedly told the American public and his union supporters, “Nothing in this plan will require you or your employer to change your coverage or your doctor.”
But that was a lie.
Millions of Americans will lose work hours, millions more will lose their healthcare, thanks to Obamacare.
Democrats are panicked and trying to suppress the cost and confusion of Obamacare.
The Washington Post reported:
I don’t know if Members of Congress will be hearing about it in town hall gatherings and other meetings back home over the Fourth of July recess, but the rolling thunder of the approaching ObamaCare train can be heard in the distance. Smart Democrats are beginning to get frantic about the need to suppress the confusion and hide the cost of ObamaCare between now and the 2014 midterm elections. We are just three months away from the October 1st enrollment start date and so far, nothing about the ObamaCare implementation process should be politically encouraging for Democrats. In fact, the more people learn about ObamaCare, the more frightened they become.
Right now, small businesses across America are making the final determinations on how to reduce the working hours of their employees so fewer employees qualify for the mandated, employer-provided health insurance. Employers are also deciding whether it makes more economic sense to pay a fine to the government or pay for healthcare benefits for their employees. What this means is that hundreds of thousands – and perhaps even millions – of Americans will learn that they are being dismissed from their employer’s healthcare coverage.
The healthcare pink slips will start raining down in late summer and early fall. This will push people into the healthcare exchanges, where, in some cases, people will be writing health insurance checks for the first time. And in many cases, people will be facing increased health insurance costs, particularly if they are young and healthy. The negative effects on personal income and the overall economy will be undeniable. Sometime next year, before the elections, the penalties associated with not having or providing health insurance will begin to pour in. Will the fines come in the mail? Will you be able to appeal? What happens if someone doesn’t pay? No one knows. Or, no one who knows is talking. The consequences of ObamaCare are being hidden.
There probably has never been a more destructive law pushed on the American public causing so much economic pain and confusion as Obamacare.
And, you can thank Democrats 100% for this disaster.
According to a new Wall Street Journal analysis, healthy Americans may see their health insurance rates double or triple upon Obamacare’s January 2014 grand opening.
Insurance premiums for sicker Americans will become less expensive as healthier Americans are forced to buy coverage or additional coverage to what they currently have or face government fines and penalties.
The Journal examined figures from eight states to demonstrate the cost increases for healthier Americans.
Virginia is one of the eight states examined by the Journal and offers a fairly typical picture.
In Richmond, a 40-year-old male nonsmoker logging on to the eHealthInsurance comparison-shopping website today would see a plan that costs $63 a month from Anthem, a unit of WellPoint Inc. That plan has a $5,000 deductible and covers half of medical costs.
By comparison, the least-expensive plan on the exchange for a 40-year-old nonsmoker in Richmond, also from Anthem, will likely cost $193 a month, according to filings submitted by carriers.
Conversely, premiums will be next to zero for a 40-year-old Virginian whose income was near the poverty level ($11,490 for a single person) due to a $234 a month government subsidy.