Recent news on Medicaid fraud has been
overflowing with egregious abuses of the system. Yet despite scandalous tales of government
funds paying for fraudsters’ Tiffany&Co
jewelry, luxury cars, and cleaning robots, we must be wary that innocents do
not become entangled in the reactionary backlash of a charitable program done
wrong. As the government attempts to
recover the money it spent too freely on Meidcaid claims, it is accusing
recipients at random and indicting community leaders who seek to bring affordable
healthcare to those in need.
overflowing with egregious abuses of the system. Yet despite scandalous tales of government
funds paying for fraudsters’ Tiffany&Co
jewelry, luxury cars, and cleaning robots, we must be wary that innocents do
not become entangled in the reactionary backlash of a charitable program done
wrong. As the government attempts to
recover the money it spent too freely on Meidcaid claims, it is accusing
recipients at random and indicting community leaders who seek to bring affordable
healthcare to those in need.
One medical martyr whose story gained national
publicity in September 2013 is Dr. Juan Villarreal, a family dentist in Harlingen,
Texas. In 2011, Dr. Villarreal was accused
of Medicaid fraud; via a credible allegation of fraud payment hold, he was
ordered to repay the state of Texas $7.8 million or face immediate suspension
of funding at the clinic he founded. For
close to two years, Dr. Villarreal was unable to provide treatment to many of
his patients, most of whom rely on Medicaid to cover their medical expenses.
publicity in September 2013 is Dr. Juan Villarreal, a family dentist in Harlingen,
Texas. In 2011, Dr. Villarreal was accused
of Medicaid fraud; via a credible allegation of fraud payment hold, he was
ordered to repay the state of Texas $7.8 million or face immediate suspension
of funding at the clinic he founded. For
close to two years, Dr. Villarreal was unable to provide treatment to many of
his patients, most of whom rely on Medicaid to cover their medical expenses.
Dr. Villarreal was known as one of the area’s
top providers for low-income patients up until the accusations, after which his
thirty years of service were forgotten and he found himself being treated like
a criminal by an impersonal entity. In the
new frontier of Medicaid
fraud investigations, there is no innocent before proven guilty. The accused are persecuted and punished
prematurely, before any verdict is reached, in an effort by the government to
save money.
top providers for low-income patients up until the accusations, after which his
thirty years of service were forgotten and he found himself being treated like
a criminal by an impersonal entity. In the
new frontier of Medicaid
fraud investigations, there is no innocent before proven guilty. The accused are persecuted and punished
prematurely, before any verdict is reached, in an effort by the government to
save money.
Legal proceedings which often take years to
resolve are obstructing time-sensitive medical treatments with frightening frequency. Even after the charges are dropped, doctors
who were acquitted must suffer routine visits from Meidcaid investigators to
ensure that their operations run legally.
While this may sound fine in theory, doctors report that the interviewers are hostile
and will harangue patients, going so far as to question children about the
purpose of their visit.
resolve are obstructing time-sensitive medical treatments with frightening frequency. Even after the charges are dropped, doctors
who were acquitted must suffer routine visits from Meidcaid investigators to
ensure that their operations run legally.
While this may sound fine in theory, doctors report that the interviewers are hostile
and will harangue patients, going so far as to question children about the
purpose of their visit.
Across the nation, justice is being obstructed
out of an overzealous attempt to correct a system with deep structural problems.
The clincher in Dr. Villarreal’s case is that he was first suspected of fraud
not because there was any allegation of fraud, but on account of his high case
load. Dr. Villarreal did not learn this
until much later, by which point he was treating his patients out of pocket to
the tune of $1.5 million.
out of an overzealous attempt to correct a system with deep structural problems.
The clincher in Dr. Villarreal’s case is that he was first suspected of fraud
not because there was any allegation of fraud, but on account of his high case
load. Dr. Villarreal did not learn this
until much later, by which point he was treating his patients out of pocket to
the tune of $1.5 million.
While cases of Medicaid
fraud in which the accused have overindulged themselves to the point of
laughable excess may be entertaining to read, we must remember that hardworking
professionals are being prosecuted simultaneously. With changes in healthcare slated to take
effect in the upcoming months we must stop the madness and arrive at a peaceable
middle ground. We must prosecute the
selfish and protect the dedicated.
fraud in which the accused have overindulged themselves to the point of
laughable excess may be entertaining to read, we must remember that hardworking
professionals are being prosecuted simultaneously. With changes in healthcare slated to take
effect in the upcoming months we must stop the madness and arrive at a peaceable
middle ground. We must prosecute the
selfish and protect the dedicated.
As always, tune in to my blog for more stories from both sides of
the field.
the field.
(Article Information from San Antonio Express News)