12/15/2022    Michael M. Rosenblatt, DPM

Medicare Advantage Plans Dodged Auditors and Overcharged Taxpayers By Millions (Paul Kesselman, DPM)

Putting aside the very sad issue of a podiatry
practice that billed Medicare Advantage Plans
fraudulently, and their CEO is now sentenced to
prison, there is a vast difference between
fraudulent actions administered by various
corporate actors, when compared to individuals,
group practices and smaller entities.

Prosecutors are not interested in jailing CEOs of
large corporations (especially insurance companies)
for even proven fraudulent activities. Instead,
their efforts are placed into fines and attempts to
recoup funds. Even those are usually negotiated out
and relatively minor by corporate attorneys. Only
rarely are the insurance companies shut down. My
wife and I had a long-term care policy with a
company that went bankrupt. None of our funds were
returned, after paying in for about 10 years. The
CEO of the insurance company was granted an
enormous termination parachute, well into the
millions. He faced no prison time or even
prosecution.

Physicians on the other hand are "low hanging"
fruit for prosecutors since they do not have the
same political power as the insurance industry.
This is not to excuse their fraud, which brings
shame on all of us. While I do appreciate Dr.
Kesselman's call to action to bring about justice
against these corporate entities, I consider that
this effort will not bear fruit. The attorneys
representing these insurers will negotiate a
settlement with Government, which will also likely
include (but not mention) an enormous corporate
contribution to the political powers in Congress.
It is all "sleight of hand."

The Life Insurance industry pays-off Congress every
year to bring about certain tax savings for their
customers when they purchase life insurance offered
by that industry. I am not particularly against
this and have taken advantage of some of these
myself. But we need to be realistic: Our Country
has a two-tiered justice system, which is sometimes
political, sometimes apolitical. This was as true
during President Lincoln's Administration as it is
now.

Michael M. Rosenblatt, DPM, Henderson, NV

There are no more messages in this thread.