Re: bypassing orthotists
Kim L. Ruhl CPO
Description
Collection
Title:
Re: bypassing orthotists
Creator:
Kim L. Ruhl CPO
Date:
2/13/2006
Text:
Robert,
The following applies strictly to Medicare patients seen by say a Don-Joy or similar sales representative. As you know private healthcare insurance transactions fall under a different set of state and federal guidelines.
To the best of my knowledge, Medicare is not currently sanctioning or prosecuting those individuals who regularly discount below Medicare allowables (engage in kickback schemes). Sadly, this present administrative folly appears to be the result of a reckless ongoing economic philosophical posture held by both the Clinton and the succeeding Bush administrations. Blatant disregard of kickback policy enforcement has been adopted by Medicare in an apparent effort to deregulate medicine and privatize Medicare. Theoretically deregulated competition and Medicare privatization should ultimately bring about lowered cost through unfettered competition and privatization's superior management skills.
The pitfall and reality of such unregulated policy blunder is a privately held, corporately managed, lowest bidder, exclusive contract, capitated healthcare provider system. This onerous shift towards an imbalance of unregulated corporate power will eventually spawn a no choice, substandard healthcare crisis immune from prosecutorial oversight. What can be done? Inform and educate your Congressional and Senatorial representatives. You can document the harm that such shallow and shortsighted unregulated policies have thus far produced and will continue to produce if left unchecked.
On the bright side, for now Medicare is still actively prosecuting some fraudulent activities. If these Don-Joy sales reps are servicing Medicare patients, they may be in violation of a number of Medicare facility guidelines. Documented violations could ultimately shut them down, and subject them to fines and or jail time. If they are operating out of the trunk of their car or some like fashion then they are in clear violation of numerous Medicare provider guidelines. If you suspect this particular violation or similar machinations are present, then I would urge you to immediately report all parties involved, including any participating physicians.
Remember what is at sake here, the health, safety and well-being of the patient, as well as the integrity and reliability of an honest system of checks and balances. These freedoms can only be enjoyed and prevail when there is an ample variety of uncoerced provider alternatives available to the patient.
The short and long of this debate:
Will we continue to support the patient's God given inalienable rights and the exercise of freedom thereof, to personally determine who best suits their individual healthcare needs.
Or
Will we allow the delicate balance of power to shift, resembling some classless mediocre third world Communistic economy where all citizens decisions and rights are conferred by a condescending and indifferent state.
As Thomas Jefferson so aptly reminds us: The price of freedom is eternal vigilance.
I have provided some official website guideline links as well an OIG Hotline number for your assistance.
Sincerely,
Kim L. Ruhl CPO
<URL Redacted> and <URL Redacted>
Office of Inspector General Hotline
To further assist you, the Office of the Inspector General maintains a hotline, which offers a confidential means for reporting vital information. The Hotline can be contacted:
By Phone: 1-800-HHS-TIPS (1-800-447-8477)
By Fax: 1-800-223-2164
(no more than 10 pages please)
By E-Mail: <Email Address Redacted>
By Mail: Office of the Inspector General
HHS TIPS Hotline
P.O. Box 23489
Washington, DC 20026
If you are attempting to report specific information proving Medicare fraud, please provide as much identifying information as possible regarding your concern. Such information should include subject's name, address and phone number etc. Details regarding the allegation should include the basics of who, what, when, where, why, and how.
Please note that it is current Hotline policy not to respond directly to written communications.
The following applies strictly to Medicare patients seen by say a Don-Joy or similar sales representative. As you know private healthcare insurance transactions fall under a different set of state and federal guidelines.
To the best of my knowledge, Medicare is not currently sanctioning or prosecuting those individuals who regularly discount below Medicare allowables (engage in kickback schemes). Sadly, this present administrative folly appears to be the result of a reckless ongoing economic philosophical posture held by both the Clinton and the succeeding Bush administrations. Blatant disregard of kickback policy enforcement has been adopted by Medicare in an apparent effort to deregulate medicine and privatize Medicare. Theoretically deregulated competition and Medicare privatization should ultimately bring about lowered cost through unfettered competition and privatization's superior management skills.
The pitfall and reality of such unregulated policy blunder is a privately held, corporately managed, lowest bidder, exclusive contract, capitated healthcare provider system. This onerous shift towards an imbalance of unregulated corporate power will eventually spawn a no choice, substandard healthcare crisis immune from prosecutorial oversight. What can be done? Inform and educate your Congressional and Senatorial representatives. You can document the harm that such shallow and shortsighted unregulated policies have thus far produced and will continue to produce if left unchecked.
On the bright side, for now Medicare is still actively prosecuting some fraudulent activities. If these Don-Joy sales reps are servicing Medicare patients, they may be in violation of a number of Medicare facility guidelines. Documented violations could ultimately shut them down, and subject them to fines and or jail time. If they are operating out of the trunk of their car or some like fashion then they are in clear violation of numerous Medicare provider guidelines. If you suspect this particular violation or similar machinations are present, then I would urge you to immediately report all parties involved, including any participating physicians.
Remember what is at sake here, the health, safety and well-being of the patient, as well as the integrity and reliability of an honest system of checks and balances. These freedoms can only be enjoyed and prevail when there is an ample variety of uncoerced provider alternatives available to the patient.
The short and long of this debate:
Will we continue to support the patient's God given inalienable rights and the exercise of freedom thereof, to personally determine who best suits their individual healthcare needs.
Or
Will we allow the delicate balance of power to shift, resembling some classless mediocre third world Communistic economy where all citizens decisions and rights are conferred by a condescending and indifferent state.
As Thomas Jefferson so aptly reminds us: The price of freedom is eternal vigilance.
I have provided some official website guideline links as well an OIG Hotline number for your assistance.
Sincerely,
Kim L. Ruhl CPO
<URL Redacted> and <URL Redacted>
Office of Inspector General Hotline
To further assist you, the Office of the Inspector General maintains a hotline, which offers a confidential means for reporting vital information. The Hotline can be contacted:
By Phone: 1-800-HHS-TIPS (1-800-447-8477)
By Fax: 1-800-223-2164
(no more than 10 pages please)
By E-Mail: <Email Address Redacted>
By Mail: Office of the Inspector General
HHS TIPS Hotline
P.O. Box 23489
Washington, DC 20026
If you are attempting to report specific information proving Medicare fraud, please provide as much identifying information as possible regarding your concern. Such information should include subject's name, address and phone number etc. Details regarding the allegation should include the basics of who, what, when, where, why, and how.
Please note that it is current Hotline policy not to respond directly to written communications.
Citation
Kim L. Ruhl CPO, “Re: bypassing orthotists,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/226137.
