Article Date: 27 Oct 2009 - 3:00 PDT

  "Medicare "provides a rich and steady income stream for criminals who are constantly finding new ways to steal a sizable chunk of the half trillion dollars that are paid out each year in Medicare benefits," 60 Minutes reports. "In fact, Medicare fraud - estimated now to total about $60 billion a year - has become one of, if not the most profitable, crimes in America." Medicare fraud leaves little evidence: an FBI agent in South Florida said "the only visible evidence of the crimes are the thousands of tiny clinics and pharmacies that dot the low-rent strip malls. You don't even know they're there because there's never anyone inside. No doctors, no nurses and no patients." Yet one of those offices, a "tiny medical supply company" charged Medicare "almost $2 million in July and a half million dollars while 60 Minutes was there in August, but we never found anybody inside, and our phone calls were never returned."'Read More

For those who are not familiar with this blog site, welcome!    

    When people find out I'm a forensic nurse, I often get the same response: Oh, CSI!  Well ... no, not exactly.

While I've heard the show certainly has some entertaining moments, in real life, cases aren't solved in an hour. Nor are they solved by only a handful of people managing every single aspect of the case.

    Forensics is the application of science to the law and it actually encompasses many fields, many different types of investigations, and a multitude of professionals - from the police and detectives to crime scene technicians; from medical examiners to emergency response personnel and crime lab experts -                                       

           ... to forensic nurses, private investigators and Accident Investigators; from criminal profilers to forensic meteorologists, and Medical Board and Fraud investigators.

It's an intricate web of professionals whose varied expertise can be paramount to the success of any one case.

 No one can stand alone. We bring together a variety of backgrounds and rely on each other to help get the job done. This is what makes this field so fascinating to me. Nothing is static and there is always so much to learn from each other.

   It's for that reason that I created this weblog. The goal is to exchange news, commentary, and information related to the application of forensics to many different fields, so as to be both interesting and informative for professionals and the general public alike.
                                                                                     
   I write my own posts when time allows, using primarily authoratative sources and experts. My posts are located in the Pages section on the left and in the archives. . . Read More

A/P Associated Press

5 mins ago

Friday, October 16, 2009
Last updated 6:59 a.m. PT

October 6, 2009

 Report Shows How Taxpayers Subsidize Dealers, Pushers & Addicts

   " Nearly 7% of all Medicaid costs (more than $20 billion per year) is allocated to pay for prescription drugs, more than $63 million of which may have gone to feed the addictions of recreational drug users last year, according to a Government Accountabily Office (GAO) report publiched last month. The report examines a practice among drug abusers known as “doctor shoppping” where addicts purchase the same type of controlled substance from numerous different doctors during the same time period for their own use or for sale on the street — with the taxpayers picking up the tab through the State-administered Medicaid program (which recieves some $80+ billion in federal assistance annually). Additionally, the GAO report identified numerous other scams by which drugs paid for by Medicaid illegally make their way to the streets, including doctors overprescribing controlled substances, writing controlled substance prescriptions without DEA authorization, and prescriptions for over “1,800 beneficiaries who were dead at that time.” Read highlights of the GAO investigation or the the full 47-page September 9 GAO report.

" According to DOJ, Michigan physical therapist, Solomon Nathaniel, pleaded guilty to conspiracy to defraud the Medicare program by creating fictitious therapy files regarding phony physical and occupational therapy services that were billed to Medicare. Nathaniel and his co-conspirators paid cash kickbacks to Medicare beneficiaries in exchange for the beneficiaries’ Medicare numbers and signatures. Nathaniel’s co-conspirator, Suresh Chand, pleaded guilty to similar charges in late September. This plea comes on the heels of other similar physical therapy related Medicare fraud schemes reported previously by FraudBlawg. The case was handled by the Health Care Fraud Prevention and Enforcement Action Team (HEAT).