In my last post I made reference to Government managed health care. I am specifically focusing on Medicare. I have documented proof of fraudulent billing, by Medicare providers. Now I will explain how difficult it is to get someone to do something about it. This is money that comes from taxpayers, and is administered by the government.
First a complaint was filed with the NCDHHS, the agency that licenses nursing homes that accept Medicare. Although we presented them with documented proof of over billing for doctor visits, pharmaceutical drugs, and quality of care, they found nothing wrong. The NCDHHS is the local agency that oversees the regulation of federal money for the DHHS. They basically ignored the fact that these things were happening, even though we have proof. We were told by Gail Maloney, the Western regional director of the NCDHHS, that they had the final say on these issues. Well technically they don't, but all the other agency's base their decisions on the findings of the NCDHHS.
Next let me tell you about CMS, the Center for Medicare and Medicaid Services. I was directed to them through Congressman Heath Shulers office. Congressman Shulers office contacted them on my behalf. I received a letter in August of 2021, saying how seriously they take Medicare fraud. The letter states that they will be contacting me directly for more information. I never heard from them so I contacted them directly. I was able to read the name and phone number although it was blacked out on the letter to Heath Shulers office. I spoke to Alfreda Walker, who told me that someone in her office was investigating the fraud issue. Ms.Walker also told me that the other issues were being investigated by a someone else.
I never heard from them till I contacted Congressman Shulers office in November 2012.They were closing their office, but they contacted CMS on my behalf. In December of 2012, I received a letter from a company called NCI Advancemed. The letter said that they had investigated my complaint and appropriate action had been taken. I called them and asked, who they were , and what action had been taken. Their response was that they took no action, they found no issues. I asked them why they never contacted me for copies of the bills, or other information. I got the typical government runaround, without ever getting a real answer. Turns out they are a private contractor, overseeing the integrity of the Medicare program! They had gotten my information from the NCDMA, from a complaint I filed with the NC Medical Board.
Turns out Ms. Walker from the CMS, had done absolutely nothing to investigate my complaint, although she had indicated that she had. What exactly happened here, I cant even explain. Who, if anybody, actually did anything? This is how the government regulates the taxpayer money paid to Medicare providers.
My brother and I both contacted NCI Advancemed, to question their results. Turns out they didn't actually have any of the information I had provided. My brother then put together a packet of information and sent it directly to them. It took about a week or maybe two for them to determine that they could not see any fraud. They did however find something, but they were not at liberty to discuss that with us. My brother is waiting for information from the freedom of information act, as I write. They are not quite so free with information, and they are definately in no hurry.
This is where we are right now, waiting. Mom died two years ago in November, and we are still waiting. I guess you can sense my opoinion of Government, and government contractor, regulated health care.
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