How Medicare And Medicaid Fraud Became A $100B Problem In The U.S.

Подписаться 3,6 млн

Просмотров 921 тыс.

50% 1

In an exclusive investigation, CNBC takes you inside how fraudsters are stealing Medicare and Medicaid funds through a wide variety of criminal operations. Special agents from the Office of Inspector General (OIG) show us how brazen these schemes have gotten from burying stolen Medicare funds in PVC pipes under a home to setting up a fraudulent business in the same building as the OIG. A convicted fraudster who served time for health care-related crimes says it’s “very easy” to make millions and stay under law enforcement’s radar because the fraud is so rampant. In a Miami shopping mall that’s been the targeted of OIG investigations, CNBC finds a medical supply company that’s billed Medicare more than $2 million in a small glass-enclosed office with someone sitting at desk, which investigators say is typical about fraudulent operations are set up. Annual Medicare and Medicaid fraud is estimated at more than $100 billion.
Senior Investigative Producer: Scott Zamost
Correspondent: Contessa Brewer
Editor: Steve Banton
Photographers: Oscar Molina, Marco Mastrorilli
Audio: Juan Merlo
Graphics: Michael Schwartz
» Subscribe to CNBC: cnb.cx/Subscri...
» Subscribe to CNBC TV: cnb.cx/Subscri...
About CNBC: From 'Wall Street' to 'Main Street' to award winning original documentaries and Reality TV series, CNBC has you covered. Experience special sneak peeks of your favorite shows, exclusive video and more.
Connect with CNBC News Online
Get the latest news: www.cnbc.com/
Follow CNBC on LinkedIn: cnb.cx/LinkedI...
Follow CNBC News on Facebook: cnb.cx/LikeCNBC
Follow CNBC News on Twitter: cnb.cx/FollowCNBC
Follow CNBC News on Instagram: cnb.cx/Instagr...
#CNBC
How Medicare And Medicaid Fraud Became A $100B Problem In The U.S.

Опубликовано:

30 сен 2024

Ссылка:

Скачать:

Готовим ссылку...

Добавить в:

Мой плейлист

Посмотреть позже

Комментарии : 1,8 тыс.

@sarahwilliams4092 Год назад

How is it so "easy it's easy, easy" for them to just take it, but damn near impossible for patients to get fully covered without going broke themselves?

@timothyodell5245 Месяц назад

Americans stealing from Americans

@jaddek.astrie3071 Месяц назад

The whole health care system is an SCAM 😢

@AnnSisuLiv Месяц назад

Easy. Govt program. They're all that useless.

@naseryaby4379 20 дней назад

Insider helps.

@TheChrisgralnic Год назад

We have to start treating fraud with more severe consequences

@tonytsai844 Год назад

The penalty should be pegged to the amount f money defrauded by the individuals. So the more "successful" they are the higher the penalty and jail time and whatever else the courts can dish out.

@gone.golfing Месяц назад

It never will because it’s not a violent crime.

@karimbulldogs1435 Месяц назад

In Islam you get your hand chopped off for stealing. Maybe sharia law isn’t so crazy after all?

@relaxationstation7374 Месяц назад

Federal laws don't apply to white people!

@cowboydelnorte3078 Месяц назад

You see how humans treat one another? “It’s not A.I. committing fraud it’s the humans.” That’s how it’ll be sold. And from speeding cars to cops killings of unarmed humans, are all data for these corporations. A.I. will be sold at the cost of human ego and greed.

@coreyashley4949 Год назад

I'm a tax paying veteran. This country allows the working class, tax paying citizens to be victims of grand disservice and unethical theft. While many of these people do get away with this, it's terrible and embarrassing to know that the rest of us are always on the hook for medical payments.

@antoniovaldez1972 Год назад

I am a tax paying astronaut

@Anthony-kn8cn Год назад

Exactly l had insurance and a pre existing condition of stenosis and scoliosis and didn't have a 1,700 dollar copay for a Dr. ordered scan to see how much worse thing's had gotten. Needless to say l left the hospital with no help and to date still deal with the condition. I asked for help and I've had to take crap job's because of my condition. This definitely hits home for me personally.@ Corey Ashley

@aronob Год назад

Man , jail for 12 years , that guy most likely got out already for good behavior reduced sentence, and got the rest of his cash he hid deep in the bunnies lol 😂 he’s gone with the cash stash for sure

@anamegoeshere Год назад

short answer is, THEY DON'T CARE ABOUT YOU OR ANYONE ELSE.

@joyceboisvert9167 Год назад

Did you know veterans are suppose to get certain benefits and when they fought in the passed 20 years laters they took all benefits away from them i seen this happen to a friend of mine who wanted to get a houxe he was in the service for 4 ywears and when he applied they refused to give it to him he was entitled for it florida took alot of veterans benefits away which is very wrong

@ronlaugsburger6991 Год назад

The people who really suffer are the people that really need good medical equipment , instead they get denied or are given the cheapest . The fraud penalties need to be increased and those in the supply chain.

@zmartenfield Год назад

I think this documentry is anti-semitic as many families rely on metioned companies, maybe business owners are taking a little advantage of medicare and midicade but 1-it's not private sector money and thier kids rely on this

@shonedocumentarymanpitts9631 Год назад

Amen Jesus Christ is close I need help as well I pray hard

@purge3883 Год назад

In America every government business there’s someone trying to steel your money

@rockon8174 Год назад

@Repent and believe in Jesus Christ dude...read the room! >:I

@meetstepsisalcoholicdouche6167 Год назад

@Repent and believe in Jesus Christ q

@velocityhawk224 Год назад

What really sucks is these thieves are making it difficult for people who actually need it.

@yuglobalcitizen2246 Год назад

Yet I had to pay $2700 out of pocket due to high deductible insurance provided by my company when I fractured my wrist then visited ER, the Dr wrapped my wrist and gave me pain killer. I simply not qualified for Medicaid because I make"too much" money as regular blue collar worker. I didn't wanton see Dr last week when I had sore throat and coughing my lungs out because it will cost me over a hundred out of pocket. And I have friend who is visiting nurse told me he went to see this patient who has Medicaid yet lives in penthouse in a building of Manhattan, the living room so huge that they put a grand piano in the center. How the heck people like that can get free medical and I have to avoid Dr after I pay thousands a year for medical insurance? What's wrong of this country?

@kl0wnkiller912 Год назад

My wife has to go to a pain management doctor. She is required to take monthly urinalysis tests in order to get her prescription for an opioid. They send the sample out for tests to an outside lab. My wife pays a deductible PLUS a 'co-insurance' payment for the testing. One day we got a bill in the mail from the lab that does the testing for four months of testing. Total cost? $20,000!!!! Turns out, the lab was inflating the cost 1500 percent because the insurance companies would only settle to pay 15% and since they paid we were not obligated to pay any more. I told them to stick their bills and reported them to the State Attorney General. They are no longer in business but had they not gotten so greedy who knows how many clueless seniors they might have continued to scam.

@reconzar Год назад

Its because they don't make an actual income, it goes into a trust so that why.

@livelovely4681 Год назад

You missed the point of this video. It’s about medicaid/Medicare fraud, by medical "providers" not buy consumers.

@kl0wnkiller912 Год назад

@@livelovely4681 Fraud is fraud though, but I get your point.

@robertminor3460 Год назад

They have inside help

@Bat_Boy Год назад

As a person who has used social services funded by tax payers, this makes my blood boil too. At sometime in your life, you might legitimately, absolutely NEED these services…and here are people stealing that tax payer money. 😡

@LassieFarm Год назад

Yep and lotta them different color than you 👍 LOL. Isn't that awful

@paidsurveys6561 Год назад

@@LassieFarm no problem when the Senators and corporations and billionaires rip it off what color are they .

@shinji1264 Год назад

Not just any ppl.. "Americans" stealing it 😂

@martingo2680 Год назад

And these people are rich already. The hospitals are overcharging and stealing. It's like stabbing us twice. Ridiculous

@dazenzi7593 Год назад

The color doesn’t matter, to be honest all these dirty politicians steals a lot more than these dudes.

@FairBeautyEssentials Год назад

America is a Corporation, not a country

@TheUnitedDrills Год назад

I Seriously Laughed Out Loud When She Called & The Phone At The Desk Rang! ☎️😂

@michaelmayo-vb5fl Год назад

Lol hit her with the old trick 😂

@TheUnitedDrills Год назад

@@michaelmayo-vb5fl 💀

@SunshineKK99 Год назад

Medicare should create a department where their representatives have to go out to the physical DME location to check it out before payment is rendered.

@tioswift3676 Год назад

That would be impossible.

@coolgamers2794 Год назад

Medicare and Medicaid do have fraud government auditor teams to verify yearly expenditure. However for law enforcement to really get involved would require probably millions of dollars lost already before legal actions are taken.

@chriswoods662 Год назад

@@tioswift3676 not in this day&age...A.I> cameras idk "drones" it would'nt be hard to document in real-time?

@daddy-orockstarmunchabunch3568 Год назад

Hard to do when only .02% of the money spent is for oversight and enforcement. This fraud is so prevalent because they’re underfunding the oversight

@chriswoods662 Год назад

@@daddy-orockstarmunchabunch3568 it could be dealt with on the authorization side (ins companies) approve these services & rates are fed/state set ( by demographics) ...once approved that money is gone....*they need a way to stop it on the front end...but idk how

@djp1234 Год назад

There are so many crooks in Miami.

@captainkirk3000 Год назад

Florida has always been a haven for corruption, Ron DeSantis is a symptom, not the cause

@fumanpoo4725 Год назад

Led by DeSatan in Tallahassee.

@fumanpoo4725 Год назад

@Joe Langel Republican men...love other hard men.

@shack12319 Год назад

The whole city was built from $ from crime of course there is

@TRasul Год назад

Agreed! They have the nerve to say “SOCIALISM IS BAD” while robbing the taxpayer blind 🥸

@blahblahblah7407 Год назад

Wait, why are doctors allowed to be selling patient info to ANYONE?! I'd be investigating that.

@Rocanala Год назад

It’s not just doctors. I’m sure staff assist in the fraud

@tpeterson9140 Год назад

that's actually insane. where I live that information is extremely sensitive and a dr is not allowed to share ur information with anyone.

@tonytsai844 Год назад

Guessing that the doctors are approached by the fraudsters and given incentives to steer business to the fraudsters for kickbacks. The legit patients are directed to the legit DME providers. Doctors can be greedy a-holes too. And if the doctors are ethical, that does not mean his employees with access to private patient data can not be bribed to give those patient information to the scammers. Just brainstorming how fraudsters can get their hands on real patient info, without going to the dark web.

@hbarudi Год назад

This should be HIPPA violation...

@paulwolf7562 Год назад

They're not allowed to be selling or giving out medical information. It's in violation of the HIPAA Law.

@mahakeem110 Год назад

Man they should get life in prison 12 years is just a bare minimum.

@thevinceberry Год назад

They should pick oranges for 12 years and all their assets confiscated, even families.

@xbabu142x Год назад

@@thevinceberry I'm confused as to why these people are not charged with conspiracy as well which is a mandatory 20 yr minimum. They seem to be running a criminal operation of their own volition and by their own will....

@dudeguy818 Год назад

@@thevinceberry yep

@AzizAhmad-n4d Месяц назад

@@xbabu142xthat's because everyone in this country that holds an office is more corrupt than the scammers.

@luisurena1770 Год назад

I used to work for an insurance company in the medicare supplement/medicare advantage plans division and almost all claims calls from "providers" were for dme... and a lot of times i got calls from patients who got billed for dme that they didn't even need or got in the first place, this explains a lot.

@Millii2703 Год назад

Who are the providers?

@luisurena1770 Год назад

@nandhu2703 any company that provides medical services, hospitals, doctors offices, nursing homes and in this case dme equipment "companies"

@ArtOg-pt4jm 26 дней назад

The "providers" change their name all the time and choose different names for different states. Trilogy. Community Research Foundation .They are the same group but both keep changing their websites and names to avoid detection and accountability. Must be fun for the IRS😅

@BillAngelos Год назад

It sounds like we need to greatly increase the penalty for defrauding the Medicaid program. Turning that 12 year prison sentence to 25 might be a good start. Seizing property, like that guys home where he buried the money wouldn't be bad either.

@ryanblanchard2508 Год назад

Spot on 👌

@bibbole5351 Год назад

100 years- is more like it-!!!!

@diapers124 Год назад

Absolutely.. because are they really going to serve all 12... Get out for good behavior... I hope that they are prohibited from owning a business ever and they should do community service when they get out as part of their probation and have to keep paying money back for the rest of their lives because they took over a system where they've really taken away from the children and adults that need medical supplies right now because they're sickly... Not including the people who are healthy now but will also be in need one day 😭

@chriswoods662 Год назад

they only recovered 2.5M ..the guy billed 49M(unless I'm mistaken)...but sounds like he has plenty more buried somewhere?

@BillAngelos Год назад

@@chriswoods662 Can't say I'm aware of the facts beyond this video. I'd love to see the legal system changed where if large sums of money aren't/or can't be recovered that they add 5 years per million dollars to the eventual sentence. Love to see them seize all the property too in an attempt to lower the financial losses.

@R4V3NBUDS Год назад

Finally, it's being reported..the doctors that do this is unreal

@pmfg875 Год назад

While shouting at patients, calling them liars, and refusing to diagnose or treat, just because they can.

@harryo989 Год назад

why dont they go after the doctors who are selling the patients information????????

@unholyrevenger72 Год назад

crooked Doctors are probably only a small portion, could be negligent disposal of documents but what I think is the biggest reason are breaches in a doctor's computer network

@ArtOg-pt4jm 26 дней назад

The problem is that there's a million "DME" like scams. There's a lot this piece leaves out. Like the fact that this is a nationwide problem in every state with a "panhandle." They are only targeting vulnerable and marginalized populations of people who are on Medicare. They also make sure nobody lives to tell the story. They either murder you or make you a vegetable. The hospitals doing this are rated #1 tops in the country. McLean hospital is one. Massachusetts General Hospital is another. "Public Research Hospitals." They rank big because they take a lot of NIH money. All research published is required to demonstrate written permission from the patients in the study. They claim that they have it and in fact they don't. People claim that public research hospitals don't exist in this country. They are stealing from patients and experimenting on them without consent. They do it to everybody now not just "the bad people." Everybody getting cancer treatment is being experimented on by big pharma. I find their stories all the time in the research.

@cuzheavy4079 Год назад

Letting people steal billions but harass people who can't pay past due medical bills smh

@daymajor4690 Год назад

GOP Senator Rick Scott should be in this video. He was CEO of Columbia/HCA when they defrauded Medicare, Medicaid etc. They were fined $1.7billion but Rick Scott left with $300 million in stock, a $5.1 million severance, and a $950,000-per-year consulting contract for five years.

@Novastar.SaberCombat Год назад

Most rich criminals are never caught. As this video notes... you only hear about a TINY, TINY, INFINITESIMALLY small percentage. And all those gobs and gobs of illegal dollars can be spent to make shady ops even more untouchable. ;) That's the system, baby! If it doesn't make dollars, then it doesn't make sense. If I had millions, I'd probably be forced to become corrupt JUST TO *SURVIVE*. Otherwise, trust me, the cartels, mafia, or yakuza would definitely wreck me, lol. Seriously, though. People need to be aware of those who are in CONTROL. Pro tip: it ain't the "governments" of any given country.

@speedingAtI94 Год назад

nah. These who got caught were small potato. Big thieves don't go to jail. They go to the congress.

@johnnycheung5536 Год назад

The Republicans who keep calling for the complete dismantlement of Medicare/Medicaid _are_ the same Republicans who benefitted handsomely for defrauding Medicare/Medicaid. Can't wait for a suffocating horde of "enlightened centrist" fake RU-vid user account trolls to mass-accuse us for being the real trolls, smear us for being libs, cite this as the reason Medicare/Medicaid must be cancelled, and still claim with a straight face that _they_ - the people committing the very fraud - are the unsung heroes in this story.

@brina6680 Год назад

You took the words out of my mouth lol rick scott is literally a snake. Shame.

@dawnladuca7938 Год назад

Yes and now he is a SENATOR from Florida HE was elected Governor after this happened. He took the 5th 75 times!! Now He has a pamphlet out to "sunset" Medicare and social security

@thelostcosmonaut5555 Год назад

Don't forget private ambulance companies and their rackets. They are one of the worst perpetrators of this and have the nerve to pay their employees next to nothing.

@ArtOg-pt4jm 26 дней назад

It's true. I tried to trace one company and wound up in the Netherlands. They had a "guarantee" every year no regardless of how many calls to receive $16 million dollars.

@HingleMacCringleberry Год назад

Greed and power are the ultimate corrupters of humanity.

@roxiewatters1161 Год назад

Exactly

@Pterygotus Год назад

This right here is why the government needs to nationalize healthcare. Anytime you get private companies able to take government money for services, you get a high potential for fraud or abuse.

@saudigold50 Год назад

Aptly said. Stellar comment.

@michaelmayo-vb5fl Год назад

Lol you just answered ur own question

@Reptanimalposts Год назад

100% of the time.

@HeronPoint2021 Год назад

That new diabetic drug that is in demand for weight loss? A Dr. reg. to do practice in New Brunswick scammed hundreds of thousands of doses (he's in Boston). Canada DID jump on it and revoke his NB license. But scammers will attempt to scam. He pulled legally a half million bonus.

@Nick_80599 11 месяцев назад

This doesn't happen in the UK.

@joemacy2776 Год назад

This is sad that our hard earned tax dollars are being stolen like this. I want my taxes to go to the people who truly need it.

@nm3547 Год назад

It's been this way for years, including within clinics. These are not the only people doing it, and hopefully this story breaks into wider curiosities, and findings.

@nm3547 Год назад

@@tayl0r612 great point, about being fixed w technology.

@Brujo2016 Год назад

Do you think it’s possible that some health clinics in the U.S. may be stealing money from Medicare/Medicaid?

@nm3547 Год назад

@@Brujo2016 of course they are. & Directly from us, as someone else mentioned, through their coding process.

@TheShootersBay Год назад

Like the Ukraine?

@itstayayg193 Год назад

Scamming is up there with murder. Sucks trust and integrity out of everything and destroys everything.

@ArtOg-pt4jm 26 дней назад

Oh no these people are actually murdering people en masse too. It's a rabbit hole 🕳️

@christopherreed3019 Год назад

I am currently doing my MBA in Healthcare Management at Temple University. In one of my classes, we discussed about Healthcare fraud and it became apparent that MEDICARE and MEDICAID were VERY prone to fraud.

@SpaceRanger187 Год назад

Hopefully you learned how not to get caught

@carloconopio6513 Год назад

Why your healthcare in us is not free compare to other countries i know its tax payers money? The us is the biggest budget in healthcare per capita compare all over the world. Wheres the money going?

@christopherreed3019 Год назад

@@carloconopio6513 The AMerican Healthcare system is very complex. From payers to Providers to the middle man, eveything is very complex which is one of the reasons why we spend a lot on healthcare

@kennethb6211 Год назад

There's a reason It's complex the more confusing you make something the more you can rip people off.

@MM-km5zf Год назад

@@carloconopio6513 US

@bronxtaskforce01 Год назад

Medicare and medicaid get robbed in broad daylight. For my dad's care, rehabilitation staff would spend less than an hour and bill hours of rehab.

@ArtOg-pt4jm 26 дней назад

Home care agencies are another dme

@LaughingOrange Год назад

12x is too good of a return for the investigators. The problem is obviously too large for the current force to handle. They should hire more investigators immediately and get that number down.

@arthurwintersight7868 Год назад

I agree. They should try to get the ROI down to about 4% annual return, which is gonna require a lot more agents.

@vladrazym9955 Год назад

Its not 12x, its 12$ per 2c. So its 600x

@krzysztofkonopka5559 Год назад

@@vladrazym9955 no, they return $12 for every $1 spent on enforcement, and they spent only 2 cents for every $100 they spent. In other words, for every $100 dollars that HHS spent, they return about 24cents.

@vladrazym9955 Год назад

@@krzysztofkonopka5559 ok, maybe I missheard this part

@elnaramuradova2454 Месяц назад

While Medicare and Medicaid is cutting reimbursements to hard working physicians making it difficult for practices to survive , these people are getting away with all that money

@ZAGIDI Год назад

Only sentence to 12,5 years? Seriously? And someone will be sentenced for more than 12.5 years for less than $50. SMH . This judicial system is discriminatory. What a shame

@nicki8731 Год назад

He probably had a really, really good lawyer.

@PlayfullWithFire Год назад

It's a non violent crime. I think that is a reasonable amount of time for millions of dollars of fraud.

@nicki8731 Год назад

yea i guess, but he did hurt people indirectly.

@paniniman6524 Год назад

Better crime than robbery i guess. The government can also be blamed for lack of rules, so 12.5 years is reasonable.

@BenzFrank Год назад

well no, u picked the wrong crime clearly... take responsibility!.

@nunyanunya4147 Год назад

got another take on faud. ive been on disability for 15 years. never talked to a doctor or shrink... noone returns phone calls. how does one get assistance even though they are disabled?

@bannor99 Год назад

If you're going to talk about healthcare fraud in Florida & NOT mention Rick Scott, you're leaving out a sizeable chunk of the story

@tioswift3676 Год назад

That case was over and done with years ago. Old news.

@bannor99 Год назад

@@tioswift3676 Rick Scott deserves to have that massive fraud attached to him for the rest of his life

@tioswift3676 Год назад

@@bannor99 Well clearly no one forgot. And it wasn’t him doing it he was the CEO of 30+ hospitals

@3markaw Год назад

@@tioswift3676 He also has a certain amount of responsibility.

@tioswift3676 Год назад

@@3markaw I agree

@blessdanny5365 Год назад

🌎 Successful people don't become that way overnight. What most people see at a glance wealth, a great career purpose is the result of hard work and hustle over time. I pray that anyone who reads this will be successful in life

@robertkiyosaki7991 Год назад

@Jonathan James Hey you're not far from making profits, she has taken care of my account for months now....I have 15wins and 2 losses so far.

@robertkiyosaki7991 Год назад

When someone is straight forward and good at what he does, people will always speak for them.

@anthonygtk8125 Год назад

@Jonathan James For me I would say give her financial education a try and you be happy you did. I've never seen someone as perfect as Clarissa

@paulwolf7562 Год назад

Hey, that's what that guy was doing. Hustling. Stealing money from people and hiding it. You guys, too? Huhhh??

@paulwolf7562 Год назад

@ErinHarvey363The guy in the video was stealing cash. More useful than your bitcoin. At least he'll see that, when he gets out...

@djayjp Год назад

Would be so easy to prevent (nearly) all of this: require photo ID and a signature from the supposed recipient of the medical treatment. Or have them login to a Medicare site (just like an IRS login). Could include 2 factor authentication with their registered number and require a licensed medical doctor's authorization.

@dianapennepacker6854 Год назад

I'm sitting here waiting for surgery paid by Medicaid. Heptorenal ‐ hopefully I can get a transplant. Its crazy people are getting away with this. I have to make sure I have an ID and fill out 100 forms. Someone might be trying to use mine but were denied.

@SBTRKT88 Год назад

Exactly! Seems like a no brainer. I guess it just makes too much sense SMH

@Alvarocious Год назад

As someone who works in healthcare. The older population would have some issues with this.

@jamalwilburn228 Год назад

They can't because Democrats are against the use of IDs due to the belief minorities are too incompetent to be expected to have an ID. Looking at their constant push to prevent voter ID

@johncolten4248 Год назад

@@Alvarocious Why?

@roboticusroboticus7912 Месяц назад

Scammers stealing from legal scammers, robbing stealing from the legal robbers. 😂 the healthcare here in America is a joke.

@TL-wy1nk Год назад

I think they should all get 20yrs. Make it a super felony.

@nlocnil3602 Год назад

Everyday Florida man outdoes himself with new antics... what a consistent king

@justinmiller1118 Год назад

We need much stronger enforcement and harsher punishment for large-scale financial crimes.

@JerryDLTN Год назад

Medicare (and Medicaid) should have current addresses, phone numbers and email adressses of Medicare and Medicaid patient/members. When a DME is ordered on the patient/members' behalf, a letter/phone call/email should be sent to the patient to confirm the order and if not confirmed or if denied, go after the provider.

@chriswoods662 Год назад

ppl move ...a lot

@ArtOg-pt4jm 26 дней назад

@BangkokZed Год назад

Some years ago a finger cut sent me to the ER. Despite only needing wound dressing, I was billed $2700. An other doctor looked at my finger for 2-3 seconds which resulted in an extra charge of $285. The experience left me very skeptical of the medical system.

@MrTom-kl7hy Год назад

Truth. The American medical system is corrupt to it's core.

@Eliastion Год назад

@CW The funniest part is that most countries do have private healthcare as well - the public sector in most of the world is chronically underfunded, leading to long waiting times and sometimes also occasionally questionable quality. But the very existence of said public sector sets up a bottom line - the private sector needs to justify its existence by providing the extra service (faster and/or better quality) at prices that people would be willing to pay. In USA the healthcare and health insurance industries basically keep the population hostage - and this imbalance of power lets them set prices and engage in practices that would never fly elsewhere. In Europe, if you have some money, you probably want to get private insurance (higher end jobs tend to include it in benefits package) and you'll mostly be using private healthcare, but the combined contribution to public healthcare you don't use and private you do use will still give you better value for money than the insurance in USA. The one exception is if you are REALLY loaded, because the top level best-money-can-buy care in USA usually is really the best-money-can-buy of the world. Then again, if you're that loaded elsewhere, you'll probably be able to use the US (or wherever the best care for your specific problem happens to be) healthcare anyway - borders aren't much of a problem for the rich.

@MuiKaHo Год назад

@CW thank god for being canadian. i went to ER once when i was a kid and didnt have to pay a dime. only bad thing is... if you need surgery and it isnt an emergency you have to wait MONTHS. like my mom needed surgery to reduce pressure in her eyes so she can see... she waited 4-5 months.

@nm3547 Год назад

@@MuiKaHo We have to wait long periods sometimes too. Even for a cardiac emergent case, sometimes.

@___beyondhorizon4664 Год назад

3 weeks ago, I was referred to see a very young cardiologist, he talked to me for 3 min, sent me to do stress test 😡 don't even pretend to check properly

@BrianGivensYtube Год назад

Theres people like this ruining lives en mass yet I see people every day getting pulled over for doing 75 in a 70 just commuting to their mundane day job.

@Sohailali1 Год назад

The general population really needs these programs and few bad apples are going to cripple it. It's sad to watch good things going down to hell.

@beng4647 Год назад

It happened a long time ago.

@michaelmayo-vb5fl Год назад

😂😂😂 they set aside a budget every year just for fraud 😂😂😂.

@williegilligan2661 Год назад

Why cant we add investigators like this, instead of IRS agents? If we follow the bills this should be easy.

@uneed2see Год назад

This is why healthcare is so expensive.

@timothyplatt3300 Год назад

ehhhh no, this is WRONG to do, don't get me wrong... but the effect on healthcare prices is minuscule. The industry is greedy, they collude, and they're inefficient (culpable to fraud as you see in the video)... they're way behind in tech, good god I'm in the process of trying to find a PCP.... none of them are in sync w/ their online platforms and there is no sync w/ the insurance data systems... it's a mess. The care is good, but the system is a mess... these small players are not what makes it so expensive

@Dacoldest23 Год назад

Absolutely not a reason

@mazenperry145 Год назад

Couldn't be more wrong, please don't give wrong information out. If we want real change for that matter.

@austinhernandez2716 Год назад

The reason it's expensive is because of capitalism. Price gouging. And you have no choice. You either get the healthcare or you die... Patents on it create monopolies too, so the prices are jacked up. The only solution is universal healthcare.

@mukkaar Год назад

Probably not even in top 100 reasons, but scummy and criminal none the less.

@stevenhenry5267 4 месяца назад

Wage theft is the biggest problem

@Cozmonimbus Год назад

It seems quite a simple solution... to show Medicare recipients a quarterly or monthly explanation of benefits and on it, show a number or website to contact to report fraudulent charges. Incentivize their reporting. They'll get a certain set amount for each firm that they report that turns out to be fraudulent.

@duaanekobe2773 Год назад

I get 2-3 calks a month from some people (from "pain management" to saying they are Medicare) wanting to send me something my doctor prescribed. As I get all medical care from the VA. I hang up. so no place or website to contact to report fraudulent charges.

@thebastardgift Год назад

Now add to that how Medicare is billed for services never rendered, nickel and dime amounts, and once reported with evidence, nothing happens other than Medicare continues to be billed for treatment never performed.

@SL-lz9jr Год назад

That kind of incentivazation could backfire too. Medicaid or Medicare recipients may be cash strapped and could start reporting legitimate businesses as fraudulent just to collect the reward.

@paulwolf7562 Год назад

I've worked my whole life, went to college, have a degree, was unemployed, went back to school, for a technical diploma, and had to find a job, because it wouldn't work. Anyways, I'm on Medical Assistance, because of medical problems and inability to get medical insurance. So, now I'm forced to take part-time. I'd love to find these people, and make them really on Medical Assistance. But, it would be permanent.

@gabrielmartinez2455 Год назад

This is everywhere now, trust me. The entire city is thriving on fraud 😂

@reneedunn683 Год назад

Now I better understand why insurance keeps getting higher. They take from us what's being stolen?😮

@wayne8797 Год назад

Why do we pay taxes when the government just throws them out to crooks? Sure the crooks needs to be charged, but the higher ups at Medicare etc also needs to take responsibility. Put their jobs at risk and see how high they jump.

@nm3547 Год назад

Unfortunately, the crooks are also in your Dr. 's and insurance office.

@JeffCaplan313 Год назад

You're asking accountants to be doctors. And THAT is the fundamental problem. Making profits in a capitalistic society is antithetical to "do no harm".

@sblijheid Год назад

@Jeff Caplan Nonsense. Why can the for profit insurance companies sniff out fraud, but a government run program cannot. The government hires inept workers and has no fraud detection measures. We need less government.

@pi5tolpete989 Год назад

It's called greed

@sebastianm.2901 Год назад

what isn´t a problem in america?

@WitchgirlViolet1313 Год назад

12 years isn't enough jail time for the fraudster. Give them longer sentences, so they will think twice before agreeing to participate in the illegal business.

@worldlife9834 Год назад

Fraud is big business in America. Our courts are clogged with minor drug possession cases.

@grapek909 Год назад

A lot of the stealing below begins with the help of homeless shelters and social services throughout the U.S. Some property owners (who receive the government funds from tenants) and government officials are involved with this theft.

@ronkirk5099 Год назад

Sounds like some minimum jail sentences of something like 25 years without parole for the multi million dollar frauds would do some good.

@angelataylor3822 Год назад

It happens in Michigan too never got my cpap medicine or back brace or anything else I need but they claim I did

@pwu8194 Год назад

I went to a dentist for routine teeth cleaning. Instead of just cleaning my teeth, they wanted to do a deep cleaning, and more, to get all the $2000 Medicare Advantage is willing to pay per year. When I went to get my teeth cleaned, they drilled on four of my good teeth to put in fillings. It's insane. It's one thing to maximize their revenue, it's another to ruin perfectly good teeth.

@juanwilliams3423 Год назад

This the real issue on alot of levels bureaucracy as well

@AlexMint Год назад

I've had dentists drill into teeth in such a manner. It's frustrating how little recourse there is for victims of such mistreatment.

@shinji1264 Год назад

@@juanwilliams3423 All America's laws are outdated

@genito1 Год назад

I am surprised you even knew they were drilling into good teeth. I just feel at the mercy of dentist every time I go or take my kids

@andrelopez2514 Год назад

oww I am so sad to hear this, sadly this doesn't happen only where you are, I am from another country and we have the same issue, better get a reliable dentist and stick to him or they will even threaten your life with those invasive expensive procedures, my mom got an infection and that was very dangerous

@isra3255 Год назад

They should be community service for life

@thevinceberry Год назад

Pick oranges for life.

@lijiang5600 Год назад

People don't just randomly find loopholes in government system of this scale. Someone from the inside gave information and is making money too, why would they solve it/enforce it

@BookofJob3XVII Год назад

It’s only illegal to steal money from medicaid if uncle Sam didn’t get his share of the profits.

@kl0wnkiller912 Год назад

They already did. The government has been robbing money from the Medicare and Social Security fund for decades. They basically stole the money we paid in and used it for something else. Pretty nuch exactly what they are arresting these people for.

@user-tc4xy6jl7o Год назад

10% for the big guy too

@bladebrowntv7822 Год назад

Bingo

@frankescobedo5593 Год назад

It's okay the Banking Cartel will just print more and bill us.

@EarlyBirdCraft Год назад

Here I am, trying to get a refund from Amazon for $34 because of a porch pirate. I still don’t feel easy for trying to get the refund😟

@SilverCymbal Месяц назад

Id rather see them spend $100m on enforcement than to give away $1B and counting.

@skyscraperfan Год назад

Thanks for giving us new business ideas! 😀

@NazarethPriest Месяц назад

CHICAGO COOK COUNTY HOSPITAL NEEDS TO BE INVESTIGATED.

@fergman300 Год назад

crime pays.... gets 12 years in prison.... steals 120 million dollars. Basically paying the guy 10 million a year to sit in prison. While justifying an entire corrupt legal system funded by taxpayers.

@jorjoperalta Год назад

He's probably only spending a few years in prison and getting out early on parole

@JeffCaplan313 Год назад

Yup.

@robertdelamare4129 Год назад

Let’s stop 🛑 all off this bull chit fraud can’t even get my teeth 🦷 fixed.

@americajordan8215 Год назад

They lie most of the time you can't even get a return call or meeting with anyone to discuss the issue even with evidence Los Angeles California 💔

@karsen7469 Год назад

Billions spent, Zero oversight, Zero accountability, what could go wrong? This is our Federal Government at work, and why you should never let them anywhere near your life.

@lolcatjunior Год назад

This wouldn't happen under nationalized health care, health care here is run by insurance ompanies that operate under loose laws can be bribed.

@karsen7469 Год назад

@@lolcatjunior How do you know? Do you have a crystal ball? These people can not clean up feces and drug needles off the streets of major cities. These people have no solution to the endless surge of homelessness in this country. These people enable crime in their communities. These people can not control the border and prevent millions of tons of fentanyl from flowing into this country. They have no solutions and only create problems that destroy everything they touch. Given their track record, you want me to allow these same people with a "lowest bidder" mentality to manage my personal health care? Are you insane, or are the drugs you are taking that good? As soon as healthcare in this country becomes nationalized, you will have two healthcare systems in this country. 1.) A system for the rich (those who can pay out of pocket for the best doctors, medicines, and facilities). 2.) A system for everyone else. As soon as you start putting caps on doctor's and nurse's salaries, fewer qualified people in this country will be willing to invest their time and money in becoming doctors due to the lack of a Return on Investment. This will create a shortage of health care providers in this country. To back fill the need for doctors and nurses, standards will be lowered to allow people, who would not have been previously qualified , to attend medical school. Furthermore, given the demand on personnel due to shortages, experienced doctors will be more inclined to move away from larger cities and to areas where there is less bureaucracy and work.

@JTSunriseMusic Год назад

The American way: lie, cheat, and steal your way to success on the backs of others

@Seanpfree Год назад

In Tennessee I see SO MANY beyond wealthy people enriching themselves further in our BROKEN health care system.

@wild_taco_gonecrazycorona9112 Год назад

How

@Seanpfree Год назад

@wild_taco_ gone crazy corona several reasons from drug prices to the agreements that insurance companies have with health services. They make up an insanely high price knowing that insurance will pay a fraction of list price so they overbill at inflated prices. Also, sales ppl who refer ppl with insurance to rehabs across this country get 25%-40% of what the rehab charges for referring them, and logistically getting them there by booking a flight. Companies like ACA in Nashville are part of the reason a rehab costs $2,000 PER DAY for the bed + the health care. That kind of thing is why hospitals charge twenty two dollars for an aspirin. Our system is broken and people are getting rich exploiting it.

@Solomeo_Paredes159 Год назад

Investigate cano health, giving a lot of equipmdnt to medicare patients that do not need or requested equipment

@MrBakedDaily Год назад

As a person who can't get health insurance because I can't afford it how does this affect me

@mimusic1853 Год назад

If your employed and income tax is being withheld from your check its your money going to these slim balls.

@MrBakedDaily Год назад

@@mimusic1853 good thing I quit paying taxes

@nm3547 Год назад

The same way all medical fraud affects you. This doesn't just happen through thugs.

@johnkeller5163 Год назад

Medicare and Medicaid government workers should be held accountable for allowing for this obvious nonsense. There is no reason why invoices cannot be checked before payment with proof of services, patient confirmation, pricing audits, and revisions of services actually needed for goal of efficiency of servicea.

@eddiekulp1241 Год назад

They must have names and real S.S. numbers to work this racket . Are some supplying there's for a kickback or all stolen

@andrej7941 Год назад

A lot of times, people don't understand big numbers like this. $100 Billion per year is a ton of money, like comparable to funding a war.

@PN-ve9lf Год назад

The very sad part this story didn't cover is how people who are dependent on this government insurance get poor coverage for their needs.

@vegassincity702 Год назад

Come to nevada Las Vegas and you'll see what medical scam is.

@MrHammer2088 Год назад

Who they buy the list of doctors and patients from? Aren't they illicit as well

@mulan7015 Год назад

That’s why people should have online accounts to manage what charges are being imposed or renew their Medicad

@mrd.808 Год назад

That's 1/10 of a trillion USD, That's a lot of $$$$$$$

@limpaway Год назад

Oh now I know why there is a medical supply store that is super far from regular foot traffic near where I live. I always wondered how they survive.

@wilwoo821 Год назад

This is happening in sf nursing homes too

@Simply.Spontaneous Год назад

It's always Florida!! 🤦🏾‍♀️🤣

@joeyinwi1514 3 месяца назад

Check out the fraud in Minneapolis

@blakespeith3698 Год назад

You work for 40yrs to have $1m in your retirement, meanwhile some people are putting just $10k in investing coins for just few months and now they are multimillionaires, all thanks to Mrs Julia, God bless you ma 👏

@walterhan3746 Год назад

I'm 37 and have been looking for ways to be successful, please how??

@davidfat15 Год назад

I earn from investing in the digital market with the guidance of experts Mrs Julia Oswin Brokerage services...

@Silas5575 Год назад

😱Sounds familiar, I have heard her name on several occasions.. and both her success stories in the wall Street journal!

@roselyn7649 Год назад

Wow wow please is there any way to reach there services, I work 3 jobs and trying to pay off my students loan for a while now!! Please help me

@roselyn7649 Год назад

@Randy George Thanks am sending her a message NOW! this is huge opportunity for me

@joekeanetv Год назад

Well, another reason to cut off Florida from federal programs, we already waste enough paying to rebuild their houses after the yearly hurricane.

@theonlythingihavetosayis9333 Год назад

Classy take from people like you...

@adifferenttake8351 Год назад

so true yet the fl governor talks about how fl is number one in the US for just about everything he considers to be good.

@robertgibson3655 Год назад

From Cuba with love. Fraudsters and fraudulent businesses.

@jovannaspann5914 Год назад

Here I am as a legitimate small business trying to get medicare certified which has taken me 2 years and counting to meet all the requirements to do business with CMS.

@chriswoods662 Год назад

that's the easy' part...fire-inspection CO (for the building)...initial audit (while you're still pro-bono)..pass< open for business...the hard''' part will be getting authorization from 4 different ins.companies(manged care) .with 4 different criteria (for that) , dealing w/ their reimbursement-rate which will be lower than on your estimated-performer (business-plan) and their rate and authorizations will get lower ...every 2 years ...GL /// hmu if u have any questions

@justintenney7227 Год назад

How can I get ahold of you Chris Woods.

@chriswoods662 Год назад

@@justintenney7227 I can call ..do you have a business line?

@amazon4716 Год назад

Get our tax payers money back Raise the charges. Stop the criminals... Don't reward them. Smh.

@chadjones2308 Год назад

Excuse me did she just say frogulent?!?!? I think she meant to say fraudulent 🤣🤣🤣🤣

@sue2019 Год назад

Infuriating! People, civil workers: this is outrageous. Think there r not enough people OVERSEEING money matters I'm each department! More Auditors.

@livetodaydietomorrowltdt2405 Год назад

I will open two DEM business in South Florida this year. If they can it, I can too. A few millions and I will retire young....headed to Thailand. 😂😂😍😍

@terihairston4921 Год назад

So very wrong ! To steal money due to patients needs. 😢

@MaLiArtworks186 Год назад

12 years is not long enough.

@paulomartins1008 Год назад

It stands to reason that the ability to create companies without enough information for these to point to their constituents for the purposes of accountability in a timely and expedite fashion is at the heart of most of the U.S.A.s economical woes. But what do I know.

@shinji1264 Год назад

All of the us laws are outdated, immigration, gun control, Medicare lmfao and politicians take a million years to change one word on a piece of paper

@sblijheid Год назад

Yeah, what do you know? Bernie Madoff was over regulated and yet he ran a ponzi.

@internetfasting80085 Год назад

Why did she do the exposition as she walked to the car? 😂 that was awkwardly pointless Just like life itself, awkwardly pointless, futile, fervent, and frivolous 😂

@JTT840 Год назад

We can learn from this video. To not put your stash in your house, even if underground. Everything else the government could control dont have budgets. Set certifications to operate like Towing company's and Key locksmith do at county level. Enforce it at some level cause 100B could cover Healthcare for most Floridians.

@Mike-Minion Год назад

This can get fixed so easily it's stupid. Just force all new businesses to get approval in a certain way and fixed. Also it will never get fixed cause they don't want it fixed. Hence why there is only 400 some odd agents. meanwhile the government wants to hire irs agents. hmmmm.

@DRAWKCABLLA Год назад

How the hell does this man only get 12 years.

@williambell4576 Год назад

And what is the governor of Florida doing, taking black history out of, arguing with Walt Disney, worrying about transgender (in truth he is the biggest woke Governor that ever existed)