The GAO estimates that10% of MediCal monies go to this type of fraud. Seems that whenever public health care budgets are attacked by the right (like Armey and Gramm) as being too large, this would be a good line of defense. A pox on all the pro-business politicians who aren't adequately regulating white collar crime.
Marta
>From the San Francisco Chronicle 12-30:
LA Times Sacramento: Another multi-million dollar Medi-Cal
scam based
in Southern Callif. has been uncovered, this one involving
stolen doctor
and patient records, state Attorney General Bill Lockyer
announced
yesterday.
The newest revelations to shake the troubled Calif. medical
program for
the poor and apparently unrelated to the federal state probe
of false
billings for medical supplies, which FBI officials estimate
may
eventually cost taxpayers more than $1 billion when it is
finally
unraveled. That giant rip-off of the Calif. Medi-Cal
system, centered
in Armenian immigrant neighborhoods of Los Angeles, is one
of the
largest frauds against a state in American history, federal
investigators said.
This time, in a sophisticated scheme that Lockyer's state
investigators
first suspected in July but are only now beginning to fully
grasp,
information from medical records is believed to have been
stolen from
hospital and clinic files. In some cases, hospital and even
government
employees are suspected of taking bribes to provide patients
lists to
the fraud ring, investigators said.
The information was used to set up phony medical operations
of ghost
doctors and phantom patients. In one case, the criminals
even used a
cardboard computer to make an office look real, Lockyer
said.
Those fake doctors' offices then billed Medi-Cal for
services never
rendered that Lockyer would only estimate in the "millions
of dollars."
"It's a continuing investigation," he said. "When you get
deeper into
it, it appears to get larger and larger."
So far, at least 20 doctors' names have been confirmed
stolen by what is
thought to be a tight-knit crime ring, and l"we've only
scratched the
surface," said Collin Wong, the new director of Lockyer's
Bureau of
Medi-Cal Fraud and Elder Abuse. Wong declined to otherwise
characterize
the ring's members, saying he did not want to harm the
investigation.
Typically, the attorney general waits to disclose details of
investigations until after it has issued indictments - an action that in this case may still be weeks or even months away. But Wong said the office decided to warn hospitals and doctors yesterday because it has so far been unable to halt the operation completely and did not want to risk losing millions of dollars more. Locyer and Gov. Gray Davis have been pursuing Medi-Cal crimes amid criticism that their predecessors ignored the abuses. State Controller Kathleen Connell's office reported yesterday that her auditors had first uncovered examples of similar schemes iln 1997, but no action was taken until after the new administration too office last January. Much of the fraud has been centered in Southern Calif., Wong said, and another state official confirmed that most of it has occurred in Los Angeles. Wong said there appear to be no links to the earlier fraud revealed in Nov., which involved dozens of fake medical equipment companies stealing Medi-Cal funds by taking payment for crutches, adult diapers and other medications that were never delivered to patients. Calif. receives about $9 billion annually in federal Medicaid money, which is matched in Calilf. by about $9 billion, benefiting 5 million poor and disabled Medi-Cal patients. The U.S. General Accounting Office estimates that nationwide about 10 percnt of that money - $1.8 billion in Calilf. is lost to fraud. S.F. Chronicle 12-30