Sunday, October 26, 2008

....it keeps getting better

The front page of today's paper gives me lots of hope for the foster care system. The judge that presides over the juvenile courts died yesterday. It's my understanding that no one has ever run against him for the position since it was created by him in 1999. I know at least one foster parent who is happy to have the chance to have her case heard by another, but for the most part he was well respected.

Below the fold was a story about a local psychologist who was recently convicted of Medicaid fraud. The fun part of it was that Medicaid didn't think there was any errors in his billing. It all comes down to the doctor's interpretation of the rule in Medicaid and who should administer the tests. In Texas and Mississippi the only person who can administer the psychological exams is the Psychologist himself. Even if their psychological assistant has a master level degree. The problem that the federal prosecutor had, that Medicaid didn't. Medicaid doesn't have two separate billing codes for administering the test and reporting the test. Of course only the Psychologist can interpret and report the test, and since there is only one billing code, it has to be billed in one lump sum. Medicaid accepts it, but apparently it is against the law.

So, since I've been actively fostering kids for long term, about 4.5 years, three of our Psychologists have been convicted under this rule. The paper says there are another three in town that are currently under investigation, and that there are only two child Psychologist's in town who still accept Medicaid. There are several thousand children in foster care in our area, all needing psychological evaluations, the government scaring off all of the doctors isn't going to do us any favors. Can't you just wait til socialized medicine? We won't have any doctors because they'll all quit before being forced to provide care and not only have the threat of being sued, but also being prosecuted for billing errors that everyone but the attorney's agree on. Blarg.

Yes, he was convicted of the fraud, but having read my share of jury instructions lately, one in our case, and on the Overton case, I'm sure they either didn't understand the circular wording or "unnecessary" wording was left out. Anyway, this fine doctor, in the last 13 years, was convicted of defrauding Medicaid of $1,950.00 yes, that's right, less than 2K. They want to send him to PRISON for 27 months. Oh and the clincher is, that at the end of the year, the crime he was convicted of will no longer be a crime. Even the judge was asking why the prosecutors had taken it this far, he won't set aside the verdict, but if even the judge is wondering why....

Hellowwww, prosecutors in the area, there are real criminals out there shooting at us. Can you go after some of them? Can you maybe send a drunk driver to jail, or maybe some sex offenders? Hey, and if you want to go after some doctors who are REALLY guilty of Medicaid fraud, try the PSYCHIATRIST who saw all of my foster children and the foster children from another family all at the same time for about ten minutes total. 8 foster children, 10 minutes, dozens of medications. Never a blood test, never a weight check, never a blood pressure check, just whatever his pharmacy rep was pushing that week. I'll give you all a million dollars if he didn't bill all eight of those children at $60/visit.

I hate my job.

1 comment:

Tracey said...

DING DONG THE WITCH IS DEAD! Thank the stars for small favors....hope the next judge in is better! I am so sorry you have to deal with this...but glad you are brave enough to do it! You're an angle!! God Bless!

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Cast of Characters

  • BOB - Born of the body children
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