Visionix

Optometrist sentenced for claiming false eye exams - KOAM TV 7 - KOAM-TV

ODwire.org NewsBot

ODwire.org NewsBot

NewsBot
Staff member
Jul 30, 2007
8,369
68
0
School/Org
Newsbot U
City
Barre
State
VT
Or...when our province decided to cover OCT testing for glaucoma / retinal (limited number allowed) with OMD's under our provincial health plan...suddenly every OMD was now buying one for each office location. And the number of OCT tests went sky high ...and now the gov't has cut back what they pay for them as they cannot afford all the tests being performed. It got to the point where most cataract patients going for surgery (no glaucoma, no retinal findings) were having an OCT prior to surgery...just because it could be done. So I asked our rep, when our OCT was installed...who are they doing billable OCT's on, because it seemed everyone was getting one at the OMD's. Her reply, and she was able to personally verify it, was that even the courier delivery people just stopping in to deliver packages into the office were getting them ! Some docs get caught and some...
 
For more information

David Bookman said:
Or...when our province decided to cover OCT testing for glaucoma / retinal (limited number allowed) with OMD's under our provincial health plan...suddenly every OMD was now buying one for each office location. And the number of OCT tests went sky high ...and now the gov't has cut back what they pay for them as they cannot afford all the tests being performed. It got to the point where most cataract patients going for surgery (no glaucoma, no retinal findings) were having an OCT prior to surgery...just because it could be done. So I asked our rep, when our OCT was installed...who are they doing billable OCT's on, because it seemed everyone was getting one at the OMD's. Her reply, and she was able to personally verify it, was that even the courier delivery people just stopping in to deliver packages into the office were getting them ! Some docs get caught and some...
Click to expand...

http://www.fbi.gov/kansascity/press...trist-from-kansas-pleads-guilty-to-wire-fraud
 
Tom Byers said:
http://www.fbi.gov/kansascity/press...trist-from-kansas-pleads-guilty-to-wire-fraud
Click to expand...

1/2 million for possible 20 yrs in prison !

In Ontario government health care insurance fraud is unfortunately not rare and usually not punished by a prison term. Due to a lack of oversight for fraud and rarely a punishment of prison time - it occurs more frequent than people suspect. One recent case involved a Toront Ontario MD. For welfare patients there is a food supplement allowance if say the patient has Crones, etc. and requires extra assisiatnce for food specific to their medical condition. This doctor, likely along with other social advocates, decided that due to the amount paid by the government for social assistance was too little and EVERYONE should get the food supplement allowance. So patient's were told by social advocates to go to his office and he will look after them. Until the government noticed one MD's bills went up and the provincial total cost for the supplement program suddenly went way up. (I believe the MD gets a fee for the work involved in filling out the form and bills the government). His defecnce was that he believed everyone should get it - even if he never completed an examination. Involved millions of dollars. Or the MD's that decided that psycotherapy insurance billing could be performed by asking every patient as they came into the office "how are you" . Those MD's billed for psych exams !
 
In a 5 month period, he billed out for 1866 phantom exams and collected $580,060. He was averaging $312.46 per exam. It seems as though the wife had no idea what was going on, I wonder what his reasoning was for the fraud.
 
Douglas Haigh said:
I wonder what his reasoning was for the fraud.
Click to expand...

$1/2 mil reasons ? Maybe he thought he would be under the radar with only this amount ? Just like somebody who has been billing stolen credit card numbers recently for parking at the airport, approx $5 each time, multiple times per month on a creduit card - as they did to mine and they probably thought - who is going to notice that on their credit card monthly bill !

Also, they caught him for that amount, was there more in the past they could not prove ?
 
David Bookman said:
$1/2 mil reasons ? Maybe he thought he would be under the radar with only this amount ? Just like somebody who has been billing stolen credit card numbers recently for parking at the airport, approx $5 each time, multiple times per month on a creduit card - as they did to mine and they probably thought - who is going to notice that on their credit card monthly bill !

Also, they caught him for that amount, was there more in the past they could not prove ?
Click to expand...
Only $5.00 for airport parking? Now that would definitely raise a red flag.

I suspect that greed got the better of them. Sad.
 
Last edited:
Tom Byers said:
Only $5.00 for airport parking? Now that would definitely raise a red flag.

I suspect that greed got the better of them. Sad.
Click to expand...

And my wife got tHe monthly credit card bill.....and said .....have you been to the airport ....several times in one month !
 
You must log in or register to reply here.
Lacrivera
Top Bottom
Back
Home
Forums
Webinars
Menu