As a physician misbehavior investigator, I see enormous flaws in any so-called 'health care reform’ that refuses to address the off-the-chart volume of doctor-related mischief. How is it that this subject is so deftly, consistently sidestepped?

Monstrous fraud; more than one million unwarranted surgeries; drug-pushing beyond reason. Our health care system provides a fertile garden for some seriously nasty critters. Chew on these points for a minute:

1. U.S. DOJ: “the estimated law enforcement cost to police & try criminal doctors and medical fraud, is 1/2 TRILLION dollars annually.” Let's all stop and stare at that number again: $500,000,000,000.

2. 11,000 physicians found criminally guilty of serious misbehavior in the last decade. Five times as many civil or ethics hearings resulted in sanctions.

3. 2009 - 2,490 doctors convicted of egregious acts.

4. 2010 - The tally for last year is now in - 2,318 MDs found "Guilty" of felonies.

When a single New York surgeon can perform & bill for 10,000 unwarranted eye operations on the mentally ill; when a team of heart surgeons can cut open 750+ healthy chests to pad their own bank accounts, AT ONE HOSPITAL; When the Michigan medical board chairman utters the words, "Yes, it can take five years to remove a child molester MD," then the only line that comes to mind was spoken on Apollo 13:

"Houston, we have a problem."

Until we weed out the lab coat lunacy and the jaw-dropping volume of doctor-theft, any other talk of “reform” is whistling past the graveyard. And I suspect that when/if that wondrous day arrives, a surprising amount of money will exist, that doesn't exist now.
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My father was admitted to a senior retirement facility last year. He was taking bloodthinners due to a blood clot in his lung. The cumiden level needed to be tested periodically. A nurse would go to the facility and draw the blood every 2-3 weeks. He would then be billed $32 for the test and $96 for the treatment room. I questioned the personel at the retirement home about the room charges and they were shocked because the facility doesn't charge for the use of the room. Several other residents were charged as well. His insurance company said the retirement facility has to be the one filing the complaint. They have nothing to do with the billing or the nurse that comes to draw the blood. When the retirement facility called them, they backed out of testing blood there anymore. What should I do?
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My father has a entire small book with evidence of Medicare fraud and he has written senators, the white house, and many others. I have personally written them too and wrote many news stations and reporters and no one responds. He contacted medicare and the lady on the other end of the phone said and I quote " What do you care its not your money". This is part of the problem complete stupidity. When a company turns in hundreds of dollars for medical tests that never happened, when a company turns in tests that were supposedly ordered by a deceased doctor, what would you call it? But they want to give a 90 yr old woman a hard time about the one medicine that got her functioning again. She had become completely disabled, my Dad who is 85 even had to bathe her and take her to the bathroom. She was in complete pain and could barely move. When I stepped in and contacted the doctors then some action started happening- they removed one medicine and put her on another medicine and she is now a functioning human being- as much as someone can be for 90. This woman worked until she was 85 years old. Now they want her to be re-certified for this medicine.I could give many more examples.
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I sposted this question but I would like you to look at it if you think fraud of double billing Medicaid for services they had been paid for since they were told they could retro the billing (I'm sure Texas Medicaid did not know my father was paid in full through May 2010).

Is it right for a nursing home to bill my father's medical and AARP insurance during the pending period for Medicaid; this is billing
for which the nursing home sent him to the hospital (due to a bladder infections) to meet the 3 day period so when he came back they were able to bill at the Skilled Nursing rate; this happen three times. He was admitted 12-2009 very quickly at the nursing home when they saw he had AARP and Medical. Medicaid was denied in April 2010; at this time all charges had were billed and paid in full with the added Skiled Nursing fees by Medical and AARP. Then the Nursing home refiled for medicaid in April 2010, in June 2010 my father was approved with Medicaid who posted it could be retroactivated. The nursing home (eventhough they were paid in full with my fathers own insurances) went back and billed Medicaid form December 2009 as if they had not received a dime; then are now, asking us to pay the monthly retro from December 2009 as if they never were paid. Also, he was denied in April, why are they entitled to Start in December and not April 2010 when the second application was made? My concern is this, why should my family have to pay all of the retro monthly (over 1,000 a month starting retro of 12-2009) payments when my fathers insurance paid before he was orig. denied? And why would Medicaid be bill too? It looks like double dipping here? If I had not applied for medicaid I would not have to pay a dime for my father was in and out of the hosiptals during his medicaid applicatio so his insurances paid.

Also...the nursing home has ask us to sign a form H1200-A, they said it is a yearly recertification; but when I looked up the form it is a program transfer? Are they planing to transfer him out of his nursing home?

Please help, I thank you for your help
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