Alleged $35 Million Medicare Fraud Reveals Doomed System
There are a lot of ways hospitals can rip you off, but this one puts them all to shame. According to the Feds, a Michigan doctor allegedly diagnosed cancer-free patients with the disease so that he could give them unnecessary chemotherapy and defraud Medicare to the tune of $35 million.
Currently Dr. Farid Fata is being held on a $9 million bond for health care fraud. If convicted, he could spend 20 years in jail.
How could a licensed medical practitioner steal $35 million from Medicare over a two year period? The FBI claims Dr. Fata misdiagnosed patients with cancer just so that he could bill Medicare for their treatment. In other words, he told healthy people to go through the hell of chemotherapy just to enrich himself in one of the country’s highest-paying professions.
Dr. Fata also reportedly prescribed chemotherapy to end-of-life cancer patients for whom the chemo’s nasty side-effects made their last days torturous. (Dr. Fata’s lawyers deny any evidence of misdiagnosis or Medicare fraud.)
Though these patients did indeed have cancer, the chemo did not cure the disease or prolong their lives…
No matter what the verdict, the case does not seem to have affected the fact that our healthcare system provides opportunities for unscrupulous doctors to siphon off huge sums of public money for their own personal gain.
First: the lack of transparency for the consumer. Yes, patients are consumers. And while it might not be feasible to comparison shop in the middle of an appendicitis attack, healthcare consumers undergoing routine or preventative medicine should be able to know how much hospitals charge for their services. Currently, very few hospitals make it easy to know the cost of treatment at their facilities, making it difficult if not impossible for patients to find good, affordable care or realize it when they are being ripped off.
Secondly, doctors are often incentivized by money rather than the overall well-being of their patients. The threat of a costly medical malpractice lawsuit ($3.6 billion in payouts were made in 2012) leads many doctors to practice defensive medicine, ordering any and all remotely relevant tests so as to protect themselves from a future lawsuit.
Additionally, most doctors are paid per test/procedure, so the more times you are poked and prodded the more money the doctor is making. What Dr. Fata allegedly did is just taking this to the next level.
Finally, incredibly complicated medical bills make it easy for doctors to commit fraud, should they be so inclined. Many patients on Medicare also have supplemental insurance, meaning they receive at least two statements for any procedure which they undergo. This leads to mountains of billing paperwork and the increased chance of a clerical error upping the final cost.
Until healthcare is well and truly reformed, don’t be surprised if you hear about more cases such as Dr. Fata’s in which the labyrinthine system of hidden costs, mixed incentives, and bureaucratic confusion give doctors the potential to commit fraud at the expense of their patient’s health and happiness.
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