Why you should question authority

By March 25, 2014 Ethics One Comment

corruption, fraud

I was on vacation over this past weekend. One evening I found myself watching TED videos. (Everyone watches educational videos on vacation, right?)

Here are a couple of winners that will inspire you to question authority from Charmian Gooch.

“They [companies] were never intended to be a moral shield.” Medicare gets a mention. This video makes me question what advantage many large rehab companies receive from being separate (but “sister” companies) from the long term care or skilled nursing facilities that they serve. Does it allow them to escape accountability? It can’t be just the recruiter marketing ploy that the company is “therapist” owned and managed?

“It’s easy to think that corruption happens somewhere over there.” “There are those that believe corruption is unavoidable. It’s just how some business is done. It’s too complex and difficult to change. So in effect, we just accept it.”

What can happen when an idea gains momentum? That’s when change starts to happen. When I met with Representative Jarod Polis’ office, I was told that part of the Medicare fraud, ethics, and elder care issues is just due to corporate America. Maybe. But as someone who has been knee deep in the turmoil of this type of care for our elders, it isn’t something that is happening “somewhere over there”. I’m in it. I’m living it. It must change.

How big are the problems with elder care and fraud?

But we aren’t in the oil, gas, and mining industry, surely the problems with Medicare fraud and poor elder care aren’t as large and important? I have not had the opportunity to sit down and look at the books for some of these companies. I don’t know how deep the problem is. Am I seeing the whole thing or just the tip of the iceberg? I think these issues are just as important.

Consider this:
“In a May 2012 report, FBI Special Agent David Welker said, “The United States spends more than $2.5 trillion on health care annually, and rough estimates indicate that anywhere from 3 (percent) to 10 percent of all health care expenditures are attributed to fraud.”If you do Welker’s math, the annual cost of fraud ranges from $75 billion to $250 billion. That’s a lot of our hard-earned retirement money.” – Bankrate

“The government recovered a historic $4.1 billion in 2011, resulting in more than $10 billion recovered since 2008.” – StopMedicareFraud.gov

“Health care fraud costs the country an estimated $80 billion a year. And it’s a rising threat, with national health care spending topping $2.7 trillion and expenses continuing to outpace inflation. Recent cases also show that medical professionals are more willing to risk patient harm in their schemes.” – FBI.gov

“Indeed, scamming Medicare and Medicaid is so lucrative that the Russian and Nigerian mobs have gotten involved. And one of the New York crime families has moved to Florida because defrauding Medicare is both more lucrative and less dangerous than some of the traditional organized crime activities.” – Forbes.com

“The fraud rings merge stolen doctor and patient data under the auspices of a shell company and then bill Medicare as rapidly as possible. Other shell companies are often layered on top to camouflage the fraud, law enforcement officials say.Some of the shells purport to be billing companies; they form a buffer between the sham clinics and Medicare. Others pay kickbacks to doctors and patients who sign off on bogus medical claims or sell their Medicare ID numbers to enable the shell company to bill the government. Still other shells act as fronts to launder the profits.The key to this kind of fraud, known as a “bust-out” scheme, is for each of the fake companies to bill as much as possible before authorities catch on. Shell companies become a tool that helps keep the crooks ahead of the cops.” – Reuters

Seems like a big deal to me.

I’m a TED geek.

I just submitted a self-nomination to speak at TEDxMileHigh (Denver) and TEDxBoulder about the advocacy work I’m doing to improve elder care and workplace environments for therapists.

Hi Mom and Dad!

My parents taught me that I should be respected and it’s okay to stir the pot.

I’m advocating for quality elder care and a reduction in Medicare fraud.

I picked a really big pot. I grow tired of stirring at times, but I’m making gains.

I’m so thankful to my parents who never told me that I’m too “little” to make big change and support me every step of the way.

Rachel Wynn
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Rachel Wynn

Speech-Language Pathologist at Gray Matter Therapy
Rachel is a speech-language pathologist and creator of Gray Matter Therapy. She started making noise as a patient-centered care advocate in 2013. She believes great care happens when patients are informed and engaged.
Rachel Wynn
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  • CSchoon

    I’m an SLP and came across the ASHA article that features you and this website. I have been working in SNFs (for multiple companies and in multiple locations) for over 9 years. Everything you are saying is 100% my experience when it comes to the productivity pushed by bigger rehab companies, I applaud your efforts to make change!