The following is a NY Post exclusive:
As debate rages in Washington over ObamaCare, New York is providing “afterworld” care — for hundreds of dead people.
State probers are hunting down pharmacies and HMOs that illegally or improperly billed Medicaid millions of dollars for dead patients, The Post has learned.
The top accused suspect thus far is Echo Pharmacy, in Miller Place, LI, and its owner Bryan McCutcheon, according to an ongoing probe conducted by New York Medicaid Inspector General James Sheehan’s office.
McCutcheon allegedly filed claims for 46 prescriptions on behalf of 17 dead patients from 2003 to 2005. Many of these patients had lived at a nearby nursing home where McCutcheon was previously employed, state investigators said.
McCutcheon claimed that the prescriptions were called in from the nursing home, investigators said. But the nursing home forbids phone-in prescriptions, according to state officials.
Effective tomorrow, Sheehan’s office is imposing a three-year ban on McCutcheon and Echo from doing business with Medicaid. It is also demanding $269,173 in restitution and fines.
Investigators would not say if the case will be referred to a law-enforcement agency.
McCutcheon is contesting the order. “Bryan and the pharmacy have never prescribed medication for a dead patient,” insisted Rex Whitehorn, the lawyer for Echo and McCutcheon.
The case appears to be just the tip of the iceberg.
The state will soon take action against New York City pharmacies for billing Medicaid more than a million dollars for prescriptions for dead patients, sources said.
The vast data-mining operation of Sheehan’s office catches up with bogus billings for dead patients by cross-checking death certificates with the dates of claims filed.
Investigators also conduct annual “deceased enrollee” audits that find HMOs routinely bill Medicaid for hundreds of dead members.
The state recovered $5 million from insurers last year and is expected to recoup even more this year, a Sheehan spokeswoman said.
For example, the office found Manhattan-based Health First billed Medicaid $635,371 for patients after they died; Metro Plus, $337,594; Americhoice of New York, $289,364; Neighborhood Health Providers, $251,474, and New York-Presbyterian Community PHSP, $242,985.
The firms bill Medicaid monthly for eligible patients, and the HMOs said there’s often a lag of weeks or months before they’re notified that a patient has died.
(Source: NY Post)
2 Responses
Question:
Were the billings for treatment given to the patients before they passed away, or for treatments supposedly administered after the patients were already niftar?
Headlines can be misleading – deliberately or otherwise.
why shouldn’t we bill medicaid for dead people? dead people odn’t exactly mind, so we might as well use their names and commeorate their memories by having their names help support poor families