Steve M. asks a question about HoagieGate:
Do we not have Medicare and Medicaid fraud in this country? Do you think we might have a bit more Medicare and Medicaid fraud if we applied the same level of scrutiny to providers’ records that we have for ordering a sandwich at a convenience store?
The biggest Medicare fraudster in this country’s history is currently the governor of Florida.
In 1997, Rick Scott was implicated in the biggest Medicare fraud case in US history, stepping down as CEO of Columbia/HCA after the hospital giant was fined $1.7 billion and found guilty of swindling the government. As Florida’s new governor, Scott is now trying to kill off an anti-fraud database that would track the fraudulent distribution of addictive prescription drugs in Florida, over the protestations of law enforcement officials, Republican state lawmakers, and federal drug policy officials.
Without consulting state lawmakers, Scott snuck a repeal of the database in his budget this year, despite the fact that it will cost Florida no money.
Now, most of you have never been to a WaWa. Here is how it works. They have several touchscreens lined up in front of the deli. You go in and tell the computer that you want a sandwich that’s four or six or eight inches long. Then you tell it that you want a certain kind of turkey with a certain kind of cheese, a little mayo or a lot, some vinegar, some onions, maybe some lettuce and tomato, hot or sweet peppers, maybe extra meat or bacon. Do you want your bread toasted? When you’re done making your choices, you get a receipt that you are supposed to take to the register. You pay for your hoagie and then they stamp your receipt. You bring your receipt back to the deli and they give you your sandwich.
The thing is, you don’t really have to pay. No one checks for the stamp on your receipt. If you want to steal the sandwich, no one is going to stop you. Of course, the whole store is under surveillance, so if you make a habit of stealing their sandwiches you will eventually be arrested. And then you’ll pay a fine, just like Rick Scott’s company had to pay after they defrauded the government. Except, this is how that works for rich Republicans.
Two whistleblowers say the new front-runner in the Republican race for governor is lying when he says he did not know about fraud in his former company, the Columbia/HCA hospital chain.
In July 1997, FBI agents raided Columbia/HCA accounting offices in seven states, including Florida. Within days, Columbia’s board of directors ousted Scott, but gave him a nearly $10 million severance package, including stock shares worth $300 million and a $1 million a year consulting contract.
The company wound up paying more than $1.7 billion for defrauding the federal Medicare and Medicaid programs.
See? It’s as if Rick Scott got caught stealing sandwiches from WaWa for his co-workers and then got fired. But he enjoyed a severance package worth well in excess of $300 million. Then he used that money to become the governor of your state and introduced a bill to eliminate cameras in convenience stores.
That’s the kind of America Mitt Romney wants to create.
Booman, when CMS (or HCFA or whatever they call themselves today) gets real about finding Medicare fraud in the administrative databases they have …
THEN I’ll get excited about catching fraud.
I ish I could draw the Venn diagram here, so instead I’ll try algebra. X+300M <
10M hence X <
-290M i.e. the rest of the package had to take $290 Million from him.O.K. there’s a lot wrong in Florida with Rick, but this is not one. This is a prescription database that cops have access to.
I posted about this before, this is a medical privacy issue, if they think I’m taking drugs illegally, get a warrant. These are medical records. What I take is between me, my doc, and the pharmacist.
I’ve dealt with pain from a spinal cord injury for 25+ years, now all of a sudden, flyers are going up in the docs office no more pain meds because they’ve got the docs scared.
Sure there are bad docs but this is a problem.
As far as I can tell, it is a system for pharmacists to check if you’ve recently had a prescription filled before they give that same prescription.
Ahh, so it’s the Rush Limbaugh law
Yes, except they’re not looking to nail Rush, but the people who wrote him scripts.
From the article…
“This is a step in the wrong direction,” said Capt. Robert Alfonso, head of the narcotics division of the Pinellas County Sheriff’s Office. “We were looking forward to using it.”
Cops will have access, and they shouldn’t.
Yes, but it’s not clear that they have access to it. The way it probably works is that the pharmacists report when they get a hit. They’re looking for script mills. Then the police follow up.
How can law enforcement use personal medical information in the database to initiate prosecutions for “doctor shopping?”
During “active investigations” regarding potential criminal activity, fraud, or theft regarding a prescribed controlled substance, a law enforcement agency may request a patient’s prescription information through the prescription drug monitoring program director. Proponents of the prescription database claim that it will be used as a tool to flag potential problems with prescriptions and alert medical staff rather than as a direct method of generating criminal charges. Supporters say it will really serve to help doctors and pharmacists who “suspect” a problem by allowing them to assess whether or not a patient is “shopping” for the prescriptions at multiple locations. On the other hand, the potential for law enforcement to comb the database during a “pending investigation” seems quite likely. In the past, such an investigation may have required a search warrant authorized by an impartial judge or at least a lawfully issued subpoena. Now, the information is available simply upon request to a bureaucratic agency.
http://www.defensehelp.com/felony-criminal-charges-lawyer/florida-prescription-drug-database
More erosion of our 4th amendment rights.
I found numerous errors in your source’s article. There’s a seven-day reporting requirement, for example, not 15 days. And I followed their link (pdf) that was supposed to buttress their case that law enforcement can register and create an account on the system,. The link makes no provision for that. It repeatedly states that only health care professionals and pharmacists are supposed to apply for accounts.
They don’t have direct access but don’t need to get a warrant or even a subpoena to get data. I could see this part of the law being challenged as illegal search. This idea that circumvents unreasonable search (patient-doctor privilege) by a program manager or support staff doesn’t pass the smell test. I’m also not saying that LE should never have access, but this corner cutting? I realize that I am arguing one small part of the law, but a circumvention all the same. This is how we lose, sloppy laws.
(c) The following entities shall not be allowed direct access to information in the prescription drug monitoring program database but may request from the program manager and, when authorized by the program manager, the program manager’s program and support staff, information that is confidential and exempt under s. 893.0551. Prior to release, the request shall be verified as authentic and authorized with the requesting organization by the program manager, the program manager’s program and support staff, or as determined in rules by the department as being authentic and as having been authorized by the requesting entity:
http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=08
00-0899/0893/Sections/0893.055.html
I should have used the actual law, but my point is supported either way.
In closing I will concede there is a major problem with prescription drug abuse, of that there is no question. But there are better ways to control it, such as e-scripting and Obama’s electronic medical record plan. These would show a doctor exactly what has already been prescribed and no additional scripts would be written. The days of a pad should be over.
One point stands out, which is that not only was Rick Scott presiding in lavish compensation over a systematic defrauding of Medicare, but that he used executive powers to protect the market for illegal distribution of prescription medications. He wants Florida to remain a national draw for small time prescription-meds dealers. Really? Is that Rick Scott’s own little angle, pushing the oxy out on the streets for a regional if not national network of small time dealers and entrepreneurs?
Basically. After all, he was trying to get state business for a company his wife “owns.” I mean like since he was elected Governor.