Fw: NY Medicaid Additional Response
Kim Edgar
Description
Collection
Title:
Fw: NY Medicaid Additional Response
Creator:
Kim Edgar
Date:
1/24/2006
Text:
Please see original response for the original post:
----------------------------------------------------------------------
Perhaps these maybe some of the reasons.
Every disabled person whom requires O&P rehabilitation is effected by the
scandal.Unregulated states like NY have no protection to recipients of O&P
servcies nor accountability of their providers.
The SEC investigation,whether found true or not, will result in a knee jerk
reaction from third party payers whom mistakenly view the whole industry of
the O&P as unregulated providers scam to rip millions off from the
reimbursement system. This is a $2 billion annual business that for the most
part remains unregulated .
Hanger (over 600 treatment facilities )controls nearly 50 % of it.
Medicaid has already eliminated and /or severely reduced O&P benefits in
several states.
Anyone whom is affiliated and familiar with their creative billing practices
knows that there are substantial bonus incentives for obtaining income
projections. Revenue projections that have artificially inflated their stock
and primary reason there are current class action law suits on behalf of
investors. The suit claims some insiders were able to bail out with nice
profit before the hammer fell.
Bonus incentives are common in other businesses except most are not
specialized unregulated health care related services.
This recent scandal which will prove to NOT be single Hanger employee
miss-coded charges in a single office and will have yet another substantial
negative credibility effect on all practitioners since Hanger Orthopedic
Group is the world's premier provider of orthotic and prosthetic patient-
care services. owning and operating 614 patient-care centers in 44 states
and the District of Columbia, with 3,385 employees including 1,016
practitioners.
Plus the fact that Hanger is the market leader in the United States.
Hanger is organized into four business segments.
The two key operating units are patient-care which consists of nationwide
orthotic and prosthetic practice centers and distribution which consists of
distribution centers managing the supply chain of orthotic and prosthetic
components to Hanger and third party patient- care centers.
The third is Linkia which is first and only managed care organization for
the orthotics and prosthetics industry.
The fourth segment is Innovative Neutronics which introduces emerging
neuromuscular technologies developed through independent research in a
collaborative effort with industry suppliers worldwide.
If Hanger providers were found guilty of the below accusations would the
Academy and ABC revoke their membership and credentials? How would they be
prevented from continuing to provide O&P services ?
The below report indicates far more than miss-coded charges.
Recent News
Prescription For Fraud?
NewsChannel 4 Investigation
UPDATED: 1:57 PM EDT June 15, 2004
The country's largest supplier of prosthetic limbs is facing investigation
for allegedly stealing from Medicare, Medicaid and insurance companies.
NewsChannel 4's Tim Minton Reports
An insider at Hanger Inc. is speaking out, and the company acknowledges an
internal audit is under way.
The insider says company policy amounts to a prescription for fraud. She
says thousands of patient files are forged or nonexistent.
None of which, she claims, stops the company from billing taxpayers for
medical devices that may or may not have been delivered.
Some of Hanger Inc.'s prosthetics were on display Monday night at a
conference for medical professionals, including shoes for diabetics and
limbs for amputees. It's a multimillion-dollar business.
But according to Hanger employee Kendall McDaniel, the money's often paid
for nothing at the company's Long Island division. She should know. She's in
charge of processing patients' bills.
They'll come in with, say, a prescription for shoes, McDaniel said. And
they'll either get the shoes, but then their insurance company will be
billed for shoes and additional items. And then I'm saying that there may be
no patient at all. Just a fake name.
The rules for reimbursement by Medicare, Medicaid and insurance companies
are strict and specific. A prescription signed by a doctor is required. And
so are notes that justify why particular equipment is necessary, given the
patient's diagnosis and condition.
McDaniel says blank Elmhurst Hospital prescription pads and official
insurance company documents are kept at the Hanger office -- where she says
she's seen a manager fill them out.
Not only prescriptions, [but also] Medicare suppliers' standards, McDaniel
said. Things that need to be in a chart in order to bill out to Medicare
are just signed as if a doctor was signing them on a day-to-day basis.
In a statement released Monday night, the New York City Health and Hospitals
Corp. said: This matter appears to involve the theft and fraudulent use of
hospital prescription pads without any knowledge of Elmhurst Hospital or the
physicians whose names were used.
The whistle blower says she has hired an attorney, Kenneth Mollins, to make
sure she can keep her job and follow the law. Mollins sent a letter to
federal and state prosecutors, requesting they review Hanger's files.
So that they can investigate whether or not millions of dollars in fraud is
taking place, and whether it's isolated to this one office, or whether or
not it's nationwide, Mollins said.
Hanger's response: The company is adamant about compliance. We are
conducting an internal audit. If there is something that is done
inappropriately, there will be strong and immediate action.
But the results of an internal audit conducted last summer and obtained by
NewsChannel 4 shows that all 15 files checked had problems complying with
the law. Issues ranged from no prescription to no justifying notes. Overall,
the company's own auditor gave a failing grade -- 50 out of 100 -- with 80
considered compliance.
In a follow-up this February -- seven months later -- the auditor sent an
e-mail to company officials warning: I am still very concerned about the
integrity of the documents I have received ... there remain numerous altered
documents.
I worked for WorldCom, McDaniel said. I got fired -- or laid off -- due
to fraud. The biggest fraud in the history of the country. I've been through
this. And I don't want it to happen again. Maybe I can stop it and tell
people. And maybe somebody else will come forward.
McDaniel has been placed on administrative leave with pay until Hanger
completes its internal audit.
The company says it has reassigned a manager implicated in forged
prescriptions and other alleged fraud to a job where he can be more closely
supervised.
June 22, 2004 06:30 PM US Eastern Timezone
CORRECTING and REPLACING Milberg Weiss Announces The Filing Of A Class
Action Suit Against Hanger Orthopedic Group, Inc. On Behalf of Investors
CORRECTION...by Milberg Weiss Bershad & Schulman LLP
NEW YORK--(BUSINESS WIRE)--June 22, 2004--Fifth graph, first sentence of
release should read: If you bought the securities of Hanger between July 29,
2003 and June 14, 2004 and sustained damages, you may, no later than August
23, 2004, request that the Court appoint you as lead plaintiff. (sted xxx no
later than September 27, 2004).
The corrected release reads:
MILBERG WEISS ANNOUNCES THE FILING OF A CLASS ACTION SUIT AGAINST HANGER
ORTHOPEDIC GROUP, INC. ON BEHALF OF INVESTORS
The law firm of Milberg Weiss Bershad & Schulman LLP announces that a class
action lawsuit was filed on June 22, 2004, on behalf of purchasers of the
securities of Hanger Orthopedic Group, Inc. (Hanger or the Company)
(NYSE:HGR) between July 29, 2003 and June 14, 2004, inclusive, (the Class
Period), seeking to pursue remedies under the Securities Exchange Act of
1934 (the Exchange Act). A copy of the complaint filed in this action is
available from the Court, or can be viewed on Milberg Weiss's website at:
<URL Redacted>
The action, numbered 04 CV 42585, is pending in the United States District
Court for the Eastern District of New York against defendants Hanger, Thomas
F. Kirk, George E. McHenry and Ivan R. Sable.
Hanger describes itself as the world's premier provider of orthotic and
prosthetic patient-care services. The Complaint alleges that, throughout
the Class Period, the Company performed poorly and that defendants were
under tremendous pressure to meet the expectations they themselves had set
and thereby maintain their credibility. The complaint further alleges that,
to achieve this end, they resorted to an illegal scheme to bilk the Medicaid
and Medicare programs, the Veterans Administration and private insurers.
Specifically, unbeknownst to investors, during the Class Period, Hanger
improperly booked sales by filling out fake prescriptions and adding items
that were not prescribed for existing patients in order to increase bills to
Medicare and Medicaid. This practice not only artificially inflated Hanger's
revenues and earnings, it also jeopardized Hanger's status as a Medicare and
Medicaid provider, and its relationships with private insurers. It was,
therefore, highly relevant to investors seeking to evaluate the
effectiveness of the Company's operations.
The truth began to emerge on June 14, 2004, after the close of trading, when
NBC News aired an investigative report in which a Hanger employee described
the Company's allegedly fraudulent billing practices. The next day, the
Company issued a news release over the PR Newswire in which it admitted that
the Company had initiated an investigation into billing irregularities.
The Company's shares had opened on June 14, 2004 at $15.75. They closed out
the day at $14.41 and fell to a closing price of $12.75 on June 15, 2004 on
heavy trading volume of 2.4 million shares for a two-day drop of 19 percent.
If you bought the securities of Hanger between July 29, 2003 and June 14,
2004 and sustained damages, you may, no later than August 23, 2004, request
that the Court appoint you as lead plaintiff. A lead plaintiff is a
representative party that acts on behalf of other class members in directing
the litigation. In order to be appointed lead plaintiff, the Court must
determine that the class member's claim is typical of the claims of other
class members, and that the class member will adequately represent the
class. Under certain circumstances, one or more class members may together
serve as lead plaintiff. Your ability to share in any recovery is not,
however, affected by the decision whether or not to serve as a lead
plaintiff. You may retain Milberg Weiss Bershad & Schulman LLP, or other
counsel of your choice, to serve as your counsel in this action.
Milberg Weiss Bershad & Schulman LLP ( <URL Redacted>) is a firm
with over 100 lawyers with offices in New York City, Los Angeles, Boca
Raton, Delaware, Seattle and Washington, D.C. and is active in major
litigations pending in federal and state courts throughout the United
States. Milberg Weiss has taken a leading role in many important actions on
behalf of defrauded investors, consumers, and others for nearly 40 years.
Please contact the Milberg Weiss website for more information about the
firm. If you wish to discuss this action with us, or have any questions
concerning this notice or your rights and interests with regard to the case,
please contact the following attorneys:
Steven G. Schulman
Peter E. Seidman
Andrei V. Rado
One Pennsylvania Plaza, 49th fl.
New York, NY, 10119-0165
Phone number: 800-320-5081
Email: <Email Address Redacted>
Website: <URL Redacted>
----------------------------------------------------------------------------
--
Thank you, Kim Edgar Office Manager
----------------------------------------------------------------------
Perhaps these maybe some of the reasons.
Every disabled person whom requires O&P rehabilitation is effected by the
scandal.Unregulated states like NY have no protection to recipients of O&P
servcies nor accountability of their providers.
The SEC investigation,whether found true or not, will result in a knee jerk
reaction from third party payers whom mistakenly view the whole industry of
the O&P as unregulated providers scam to rip millions off from the
reimbursement system. This is a $2 billion annual business that for the most
part remains unregulated .
Hanger (over 600 treatment facilities )controls nearly 50 % of it.
Medicaid has already eliminated and /or severely reduced O&P benefits in
several states.
Anyone whom is affiliated and familiar with their creative billing practices
knows that there are substantial bonus incentives for obtaining income
projections. Revenue projections that have artificially inflated their stock
and primary reason there are current class action law suits on behalf of
investors. The suit claims some insiders were able to bail out with nice
profit before the hammer fell.
Bonus incentives are common in other businesses except most are not
specialized unregulated health care related services.
This recent scandal which will prove to NOT be single Hanger employee
miss-coded charges in a single office and will have yet another substantial
negative credibility effect on all practitioners since Hanger Orthopedic
Group is the world's premier provider of orthotic and prosthetic patient-
care services. owning and operating 614 patient-care centers in 44 states
and the District of Columbia, with 3,385 employees including 1,016
practitioners.
Plus the fact that Hanger is the market leader in the United States.
Hanger is organized into four business segments.
The two key operating units are patient-care which consists of nationwide
orthotic and prosthetic practice centers and distribution which consists of
distribution centers managing the supply chain of orthotic and prosthetic
components to Hanger and third party patient- care centers.
The third is Linkia which is first and only managed care organization for
the orthotics and prosthetics industry.
The fourth segment is Innovative Neutronics which introduces emerging
neuromuscular technologies developed through independent research in a
collaborative effort with industry suppliers worldwide.
If Hanger providers were found guilty of the below accusations would the
Academy and ABC revoke their membership and credentials? How would they be
prevented from continuing to provide O&P services ?
The below report indicates far more than miss-coded charges.
Recent News
Prescription For Fraud?
NewsChannel 4 Investigation
UPDATED: 1:57 PM EDT June 15, 2004
The country's largest supplier of prosthetic limbs is facing investigation
for allegedly stealing from Medicare, Medicaid and insurance companies.
NewsChannel 4's Tim Minton Reports
An insider at Hanger Inc. is speaking out, and the company acknowledges an
internal audit is under way.
The insider says company policy amounts to a prescription for fraud. She
says thousands of patient files are forged or nonexistent.
None of which, she claims, stops the company from billing taxpayers for
medical devices that may or may not have been delivered.
Some of Hanger Inc.'s prosthetics were on display Monday night at a
conference for medical professionals, including shoes for diabetics and
limbs for amputees. It's a multimillion-dollar business.
But according to Hanger employee Kendall McDaniel, the money's often paid
for nothing at the company's Long Island division. She should know. She's in
charge of processing patients' bills.
They'll come in with, say, a prescription for shoes, McDaniel said. And
they'll either get the shoes, but then their insurance company will be
billed for shoes and additional items. And then I'm saying that there may be
no patient at all. Just a fake name.
The rules for reimbursement by Medicare, Medicaid and insurance companies
are strict and specific. A prescription signed by a doctor is required. And
so are notes that justify why particular equipment is necessary, given the
patient's diagnosis and condition.
McDaniel says blank Elmhurst Hospital prescription pads and official
insurance company documents are kept at the Hanger office -- where she says
she's seen a manager fill them out.
Not only prescriptions, [but also] Medicare suppliers' standards, McDaniel
said. Things that need to be in a chart in order to bill out to Medicare
are just signed as if a doctor was signing them on a day-to-day basis.
In a statement released Monday night, the New York City Health and Hospitals
Corp. said: This matter appears to involve the theft and fraudulent use of
hospital prescription pads without any knowledge of Elmhurst Hospital or the
physicians whose names were used.
The whistle blower says she has hired an attorney, Kenneth Mollins, to make
sure she can keep her job and follow the law. Mollins sent a letter to
federal and state prosecutors, requesting they review Hanger's files.
So that they can investigate whether or not millions of dollars in fraud is
taking place, and whether it's isolated to this one office, or whether or
not it's nationwide, Mollins said.
Hanger's response: The company is adamant about compliance. We are
conducting an internal audit. If there is something that is done
inappropriately, there will be strong and immediate action.
But the results of an internal audit conducted last summer and obtained by
NewsChannel 4 shows that all 15 files checked had problems complying with
the law. Issues ranged from no prescription to no justifying notes. Overall,
the company's own auditor gave a failing grade -- 50 out of 100 -- with 80
considered compliance.
In a follow-up this February -- seven months later -- the auditor sent an
e-mail to company officials warning: I am still very concerned about the
integrity of the documents I have received ... there remain numerous altered
documents.
I worked for WorldCom, McDaniel said. I got fired -- or laid off -- due
to fraud. The biggest fraud in the history of the country. I've been through
this. And I don't want it to happen again. Maybe I can stop it and tell
people. And maybe somebody else will come forward.
McDaniel has been placed on administrative leave with pay until Hanger
completes its internal audit.
The company says it has reassigned a manager implicated in forged
prescriptions and other alleged fraud to a job where he can be more closely
supervised.
June 22, 2004 06:30 PM US Eastern Timezone
CORRECTING and REPLACING Milberg Weiss Announces The Filing Of A Class
Action Suit Against Hanger Orthopedic Group, Inc. On Behalf of Investors
CORRECTION...by Milberg Weiss Bershad & Schulman LLP
NEW YORK--(BUSINESS WIRE)--June 22, 2004--Fifth graph, first sentence of
release should read: If you bought the securities of Hanger between July 29,
2003 and June 14, 2004 and sustained damages, you may, no later than August
23, 2004, request that the Court appoint you as lead plaintiff. (sted xxx no
later than September 27, 2004).
The corrected release reads:
MILBERG WEISS ANNOUNCES THE FILING OF A CLASS ACTION SUIT AGAINST HANGER
ORTHOPEDIC GROUP, INC. ON BEHALF OF INVESTORS
The law firm of Milberg Weiss Bershad & Schulman LLP announces that a class
action lawsuit was filed on June 22, 2004, on behalf of purchasers of the
securities of Hanger Orthopedic Group, Inc. (Hanger or the Company)
(NYSE:HGR) between July 29, 2003 and June 14, 2004, inclusive, (the Class
Period), seeking to pursue remedies under the Securities Exchange Act of
1934 (the Exchange Act). A copy of the complaint filed in this action is
available from the Court, or can be viewed on Milberg Weiss's website at:
<URL Redacted>
The action, numbered 04 CV 42585, is pending in the United States District
Court for the Eastern District of New York against defendants Hanger, Thomas
F. Kirk, George E. McHenry and Ivan R. Sable.
Hanger describes itself as the world's premier provider of orthotic and
prosthetic patient-care services. The Complaint alleges that, throughout
the Class Period, the Company performed poorly and that defendants were
under tremendous pressure to meet the expectations they themselves had set
and thereby maintain their credibility. The complaint further alleges that,
to achieve this end, they resorted to an illegal scheme to bilk the Medicaid
and Medicare programs, the Veterans Administration and private insurers.
Specifically, unbeknownst to investors, during the Class Period, Hanger
improperly booked sales by filling out fake prescriptions and adding items
that were not prescribed for existing patients in order to increase bills to
Medicare and Medicaid. This practice not only artificially inflated Hanger's
revenues and earnings, it also jeopardized Hanger's status as a Medicare and
Medicaid provider, and its relationships with private insurers. It was,
therefore, highly relevant to investors seeking to evaluate the
effectiveness of the Company's operations.
The truth began to emerge on June 14, 2004, after the close of trading, when
NBC News aired an investigative report in which a Hanger employee described
the Company's allegedly fraudulent billing practices. The next day, the
Company issued a news release over the PR Newswire in which it admitted that
the Company had initiated an investigation into billing irregularities.
The Company's shares had opened on June 14, 2004 at $15.75. They closed out
the day at $14.41 and fell to a closing price of $12.75 on June 15, 2004 on
heavy trading volume of 2.4 million shares for a two-day drop of 19 percent.
If you bought the securities of Hanger between July 29, 2003 and June 14,
2004 and sustained damages, you may, no later than August 23, 2004, request
that the Court appoint you as lead plaintiff. A lead plaintiff is a
representative party that acts on behalf of other class members in directing
the litigation. In order to be appointed lead plaintiff, the Court must
determine that the class member's claim is typical of the claims of other
class members, and that the class member will adequately represent the
class. Under certain circumstances, one or more class members may together
serve as lead plaintiff. Your ability to share in any recovery is not,
however, affected by the decision whether or not to serve as a lead
plaintiff. You may retain Milberg Weiss Bershad & Schulman LLP, or other
counsel of your choice, to serve as your counsel in this action.
Milberg Weiss Bershad & Schulman LLP ( <URL Redacted>) is a firm
with over 100 lawyers with offices in New York City, Los Angeles, Boca
Raton, Delaware, Seattle and Washington, D.C. and is active in major
litigations pending in federal and state courts throughout the United
States. Milberg Weiss has taken a leading role in many important actions on
behalf of defrauded investors, consumers, and others for nearly 40 years.
Please contact the Milberg Weiss website for more information about the
firm. If you wish to discuss this action with us, or have any questions
concerning this notice or your rights and interests with regard to the case,
please contact the following attorneys:
Steven G. Schulman
Peter E. Seidman
Andrei V. Rado
One Pennsylvania Plaza, 49th fl.
New York, NY, 10119-0165
Phone number: 800-320-5081
Email: <Email Address Redacted>
Website: <URL Redacted>
----------------------------------------------------------------------------
--
Thank you, Kim Edgar Office Manager
Citation
Kim Edgar, “Fw: NY Medicaid Additional Response,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/225982.
