Medicare Fraud and Abuse The Most Profitable Healthcare Crime in the U.S.

Medicare fraud and abuse cost taxpayers approximately $60 billion a year. Its one of the fastest and most profitable crimes in the U.S. The government health insurance program that covers 46 million elderly and disabled Americans is being hijacked by opportunists preying on patients, doctors, suppliers, and lack of oversight of the system itself.

According to President Obama, Medicare fraud and abuse is fueling enormous federal budget deficits. He recently explained that we could pay for healthcare reform if we could eliminate Medicare fraud, abuse, and waste altogether.

Although completely eliminating Medicare fraud isnt entirely realistic, curbing the growing crimes could provide healthcare to many more Americans and stop lining the pockets of the individuals, crime rings, and corrupt healthcare providers that steal a huge amount of the half trillion dollars in Medicare benefits each year.

The instances of Medicare fraud and abuse are as diverse as they are widespread. One recent high-profile case involved an Armenian-American crime syndicate that stole patient and doctor identities to setup dozens of fake clinics. The operation, which is one of the largest Medicare fraud schemes in U.S. history, resulted in over $35 million in illegal billings.

In another Medicare fraud and abuse case, nine hospitals in seven states were ordered to pay $9.4 million in fines for keeping patients overnight after undergoing what is typically an outpatient back procedure. The hospitals fraudulently billed Medicare for the unnecessary services. In still another case, eight nurses in Florida carried out an $18.7 million Medicare fraud scam in which they forged patient files to make it appear that they required home health care services that they didnt need or receive.

Although these are just a few of the many types of Medicare fraud and abuse scams occurring each year, they show the urgent need to be vigilant about preventing Medicare scams. From charging for durable medical equipment (DME) never received to using a deceased doctors information to continue to bill patients, common Medicare fraud and abuse schemes include:

* Advertising “free” consultations to patients with Medicare, and then recording and using their private information for monetary gain

* Offering healthcare services or DME for free in return for a persons Medicare number for “record keeping”

* Setting up fictitious clinics with people impersonating doctors to steal private information and commit medical identity theft is another common Medicare fraud and abuse tactic

* Using real patients data, but without their knowledge, to steal their identities

* Not adhering to the FTC Red Flag Rules that alert the carriers paying the bills

* Fraudulent billing for a wheelchair, specialized hospital bed, or other DME is also a form of Medicare fraud and abuse

* Falsifying claims for expensive procedures is another common tactic, such as the $5.8 million fraudulent HIV infusion scheme in Miami in which a husband and wife team defrauded Medicare by submitting unnecessary HIV injection and infusion claims

Remember that when fraud happens to Medicare, it happens to all of us. Dont let your organization become a victim. Put your employees on the front line to spot Medicare fraud by hiring a healthcare fraud and abuse expert that provides “Lunch and Learn” presentations to help avoid, recognize, and respond to Medicare fraud. Visit www.TheIdentityAdvocate.com. or call 310.831.4400 to learn how to prevent Medicare fraud and medical identity theft.

Information about how to identify skin cancer signs or symptoms

Spot basal cell carcinoma

Doctors suggest that you perform a monthly head to feet inspection yourself for suspicious spots on your skin. You ought to take a look for this frequent skin cancer symptoms on your chest, back, ears, face and neck. The overwhelming majority of instances of basal cell carcinoma happen in these areas on the body.

The hallmark symptoms from the occurrence of this condition are bumps or skin lesions. Bumpy, basal cell growths are usually white having a waxy consistency and are typically located within your facial area. Lesions usually form on the chest or back and may mimic flesh tones or appear to become brownish. They appear like scars that form in an area where there is no history of skin injury.

Squamous cell carcinoma: points to search for

This form of carcinoma could be treated successfully if discovered early, and it tends to develop on the hands, arms, neck, ears, face and lips. Specifically should you go to tanning salons and spas or get a excessive level of sun exposure, you ought to look for reddish, oblong bumps or crusty lesions that form without reason.

Check your skin for signs of melanoma

Melanoma, a potentially deadly form of skin cancer, can happen anyplace on your body but specifically on your face or back, and it may even form in benign skin moles you have had your entire life. If you notice moles on your body changing color, bleeding spontaneously or building oozing, crusty edges, pay a visit to a health-care professional right away.

When conducting your month-to-month self-examination, check for bumps, sores and skin lesions which can be dark, irregularly shaped and shiny or painful to the touch. These abnormal growths may well have speckles and range in color from brownish and red to black and blue. Verify the palms of your hands, inside your mouth and nose and your anus or vagina for symptoms of melanoma, as these dangerous tumors can develop in places you might not anticipate.

Don’t overlook uncommon forms of skin cancer

When you have a affected immune system or are afflicted with HIV or AIDS, you’re at elevated danger of having Kaposi’s sarcoma. You can recognize the symptoms of this relatively rare form of skin cancer by checking for reddish or purple splotches on your skin. Kaposi’s sarcoma is a cancer of the skin’s blood vessels.

Merkel cell carcinoma, while rare, is hazardous because it may be difficult to spot. Lurking inside the scalp or simply underneath the skin, this cancer is comparatively large–1/4 inch to two inches–and will seem reddish, pinkish or blue. Your skin’s oil glands, specifically within your eyelids, may well host sebaceous-gland carcinoma. This quickly spreading skin cancer can effortlessly be mistaken for a non-threatening condition, given its brown, all-natural appearance and painless. Finally, a range of precancerous skin circumstances can result in squamous cell carcinoma. The most typical is actinic keratosis, identified primarily in light-skinned individuals. These growths, while noncancerous, can soon turn lethal and are defined by uneven, bumpy spots that usually take on a brown or pink color.