Offering further proof that health insurance fraud and abuse aren't victimless crimes, recent scams share a theme of patient exploitation and endangerment. Here are four prominent cons worth noting, according to Listverse, an on-line compiler of knowledge lists.
1. Surgical abuses
Medicare patients at Chicago's Sacred Heart Hospital received invasive procedures they didn't need, including prolonged sedation, tracheotomies and penile implants as FierceHealthPayer: Anti-Fraud reported. One of the hospital's physicians, Vittorio Guerriero, M.D., allegedly induced breathing complications in at least 28 patients to justify drilling holes in their throats, Listverse reported. Five people died as a result.
Then there's the case of orthopedic surgeon Spyros Panos, M.D., who scheduled up to 22 daily operations at Saint Francis Hospital in Poughkeepsie, New York. That was almost 20 times more than the specialty norm. Patients filed 250 lawsuits that allege Panos performed excessive surgeries or failed to complete them. Panos also reportedly incised and closed some patients to give the appearance of surgery without actually doing anything on their insides, the article stated. After admitting to botching and faking thousands of procedures, Panos was sentenced to four and a half years in prison for healthcare fraud.
2. Overused chemotherapy
Michigan oncologist Farid Fata, M.D., faces a decade in prison for allegedly billing patients in remission for chemotherapy, purposefully misdiagnosing beneficiaries with cancer to justify chemotherapy and fabricating diagnoses as reasons for ordering hematology treatments. A nurse Fata employed reported reviewing medical records for 40 of Fata's patients and finding 95 percent received improper treatment, Listverse noted.
3. Rounding up the homeless for unnecessary care
Los Angeles-based medical facilities used runners to recruit and pay homeless people to pile into ambulances and travel to hospitals for needless care, the article stated. One woman received a nitroglycerin patch for a fictional illness, causing her blood pressure to drop dangerously. Bogus hospital care resulted in a $16 million overpayment.
4. Convincing addicts to enter lockdown units
Executives of a Florida psychiatric hospital paid bribes and then altered documentation to hide the practice of luring drug addicts to their hospital, Listverse reported. "[P]atients were stuffed into insect-ridden rooms where they received little or no treatment," the article stated, "and were kicked out as soon as their Medicare benefits [were] exhausted."
- here's the Listverse article