Need some advice concerning medical fraud

[shiner]

Ok...here's the deal....A friend of mine works at a home health agency and found out yesterday that the her boss maintains a file of Dr's signatures so that she can forge medical paperwork whenever they can't get a Dr. to sign off on something. From what she understands the owner knows about the file and that it is used from time to time. My friend also says that it's pretty common knowledge in the office that this goes on but that people tend to ignore it because the signature file is normally only used when a Dr. is too busy to sign something or when a Dr. is out of town and they need them to sign off on something. She has only been working there for 3 months and just found out about the file on Friday. She did some asking around and the rest of the staff says that the various Dr's are unaware that this goes on. She really has a problem with what the agency is doing and plans to quit on Monday morning. She would also like to report them to someone but really doesn't know who to call. Anyone on here ever dealt with something like the before or have any ideas about what agency needs to be contacted about the forgeries?

 

[johnjohn320]

The Police.

 

[shiner]

Originally posted by: johnjohn320
The Police.

Doesn't seem like the police would be the people to contact about something like this. From dealing with the police force in the past they tend to overlook this kid of stuff or tell you to contact some state or federal agency. The company I work for got called into to rebuild a companies server farm after their Admin fvcked them over and committed all sorts of cyber crime, that I can't really talk about, they police refused to even come on location and look at anything even though some equipment was stolen. Whenever the company called them after we found out what happened they just kept telling them to call the FBI. The FBI wouldn't come out until the local police looked at things....all a damn vicious circle. Sorry....I got off topic....I guess my point is that the police around here just wouldn't care and would drop the ball on something like this.

 

[wnied]

This type of file is a somewhat common practice to keep on hand, but its ALWAYS kept with all that vendors doctors knowledge & permission. (speeds the processing of medical documents along) Unless she has proof of any wrong doing, it might be smart for her to sit put and gather information to use against said company for use in a "whistle blower" suit.

~wnied~

 

[crypticlogin]

Anyone on here ever dealt with something like the before or have any ideas about what agency needs to be contacted about the forgeries?

If I'm thinking of the same type of business that you're referring to, then I'll say your state's Department of Public Health (they're usually named that). There was a case around here a few years ago that involved a visiting nurse service and after the DPH got involved, they were shut down.

 

[shiner]

Originally posted by: wnied
This type of file is a somewhat common practice to keep on hand, but its ALWAYS kept with all that vendors doctors knowledge & permission. (speeds the processing of medical documents along) Unless she has proof of any wrong doing, it might be smart for her to sit put and gather information to use against said company for use in a "whistle blower" suit.

~wnied~

That's what I thought in the beginning when she was first telling me about it. Then she got into how the file is actually maintained/used and it just sounds shady. I work for a consulting firm and I'm on site at one of our larger customers which just happens to be a hospital. Signature files are commonly kept and we even have an electronic signature system that all the electronic medical records are signed with. From what she says this file contains copies of orders Dr's have written, other forms Dr's have filled out, etc...so that they have something to copy the Dr's signature from. The way she found out about this was that the girl at the desk next to here was copying a Dr's signature onto a medical form for supplies that she had just finished filling out. She had a copy of an older form the Dr had signed some months ago under the form she was filling out and was tracing over the Dr's signature. That doesn't seem like a normal signature file to me, at least not the way the use them at the hospital where I'm located. My friend also has suspicions that her boss uses the file to write herself prescriptions when she doesn't want to go to the Dr.

 

[Ylen13]

being in medical profession this kind of stuff is actually standard practice. Most of the time their is a book were all of the doctors sign and if if doctor signature ever needed and he is to busy to sign or he is not their, they have a person that is capabel to sign for any of them just by looking at his signature. Unless the person signed something that is very serious or the doctor specifically refused to sign and they sign for him no crime have been commited.

 

[shiner]

Originally posted by: Ylen13
being in medical profession this kind of stuff is actually standard practice. Most of the time their is a book were all of the doctors sign and if if doctor signature ever needed and he is to busy to sign or he is not their, they have a person that is capabel to sign for any of them just by looking at his signature. Unless the person signed something that is very serious or the doctor specifically refused to sign and they sign for him no crime have been commited.

See my post just above yours. This is all being done without the Dr's knowledge.

 

[Ylen13]

Originally posted by: shinerburke

Originally posted by: Ylen13
being in medical profession this kind of stuff is actually standard practice. Most of the time their is a book were all of the doctors sign and if if doctor signature ever needed and he is to busy to sign or he is not their, they have a person that is capabel to sign for any of them just by looking at his signature. Unless the person signed something that is very serious or the doctor specifically refused to sign and they sign for him no crime have been commited.

See my post just above yours. This is all being done without the Dr's knowledge.

hmm that is strange.I personally would quite, wouldn't wante to be associated with a company that dose this. Now reqarding this specific case, dose she know what doctor signature it was.If so have she tried talking to him to see if authorized them to sign or not.(never know if it was authorized thru a phone conversation) But i do agree this don't see to be standard practice. Also im sure the Dr. would love to know if this is going on.

 

[shiner]

I should probably also add that my friend is very conflicted about actually reporting them since the woman that is her boss is the daughter of one of her Aunt's best friends.

 

[Ylen13]

Originally posted by: shinerburke
I should probably also add that my friend is very conflicted about actually reporting them since the woman that is her boss is the daughter of one of her Aunt's best friends.

Oh great this is getting little to ugly. Tell her to quite. Really wouldn?t want to be their when this hole things collapse have a feeling each one will be blaming someone else for doing it and claims they never did it them self.

 

[Ylen13]

btw what state is this in just wondering?

 

[jemcam]

Originally posted by: Ylen13

Originally posted by: shinerburke
I should probably also add that my friend is very conflicted about actually reporting them since the woman that is her boss is the daughter of one of her Aunt's best friends.

Oh great this is getting little to ugly. Tell her to quite. Really wouldn?t want to be their when this hole things collapse have a feeling each one will be blaming someone else for doing it and claims they never did it them self.

How about contacting one of the insurance carriers? They'll look into it, and if there's fraud being perpetrated, they'll investigate. After all, they're the ones that are probably suffering the most.

 

[Ylen13]

Originally posted by: jemcam

Originally posted by: Ylen13

Originally posted by: shinerburke
I should probably also add that my friend is very conflicted about actually reporting them since the woman that is her boss is the daughter of one of her Aunt's best friends.

Oh great this is getting little to ugly. Tell her to quite. Really wouldn?t want to be their when this hole things collapse have a feeling each one will be blaming someone else for doing it and claims they never did it them self.

How about contacting one of the insurance carriers? They'll look into it, and if there's fraud being perpetrated, they'll investigate. After all, they're the ones that are probably suffering the most.

Well it all depends on what scale the fraud is.If its pretty small scale they probeably will not borther, but then again just depends what investigater gets the case. Now it also depends what forms,perscritptions etc were forged. Reason i say that is because if the forms were so common signed by this doctor then the staf will just claim he forgot.

 

[shiner]

She's quitting. Her mind is made up about that. She never really liked the job anyway and only took it as a favor to her boss. They needed someone to help get their accounting in order after the owner fired the entire accounting staff when she threw a fit one day. My friend went in and started getting a new accounting staff together and the books back in order. She's never been comfortable there nor like the job. She's lucky in that she has had several offers to go elsewhere so she won't have to look for a job. The whole damn thing is a mess from what she tells me. The owner is an older lady that insists there always be a hot cup of coffee on her desk when she comes to work in the morning or when she comes back from lunch. Not really that big of a deal right? Well she fired the receptionist the week before Christmas because she got to work and the coffee hadn't been made yet. She's told me some real horror stories about the owner. Long story short is that she stayed around out of loyalty to her Aunt's friend. That's run out though and she is out of there. She's just still undecided about reporting them to someone. Personally I think the place sounds sleazy and needs to be shut down.

 

[shiner]

Originally posted by: Ylen13
btw what state is this in just wondering?

Oklahoma

 

[shiner]

Originally posted by: jemcam

How about contacting one of the insurance carriers? They'll look into it, and if there's fraud being perpetrated, they'll investigate. After all, they're the ones that are probably suffering the most.

Well this place deals almost entirely with Medicaid/Medicare. It's a home health agency for the elderly and 99% of their clients are on Medicaid or Medicare. You know how that crap goes as far as fraud is concerned.....I doubt they would even look into it.

My friend is considering calling one of the local television stations and talking to them. I have another friend who is a reporter for one of the stations and I know should would love to get her teeth into something like this. Just not sure that's the correct route to take.

 

[Ylen13]

Originally posted by: shinerburke

Originally posted by: Ylen13
btw what state is this in just wondering?

Oklahoma

Just glad is not Southern California. Oh tell your friend good luck and if she can't sleep at night because of this, tell her make anonymous call to department of health services and let them worry about this.

 

[Ylen13]

Originally posted by: shinerburke

Originally posted by: jemcam

How about contacting one of the insurance carriers? They'll look into it, and if there's fraud being perpetrated, they'll investigate. After all, they're the ones that are probably suffering the most.

Well this place deals almost entirely with Medicaid/Medicare. It's a home health agency for the elderly and 99% of their clients are on Medicaid or Medicare. You know how that crap goes as far as fraud is concerned.....I doubt they would even look into it.

My friend is considering calling one of the local television stations and talking to them. I have another friend who is a reporter for one of the stations and I know should would love to get her teeth into something like this. Just not sure that's the correct route to take.

Read my respond above, department of health services is the one she should contact off course the local reported can do that for her also.

 

[Tripleshot]

Another case of abuse of the public trust, and in the medical profession. Why do we pay doctors as much as we do, so they can defraud us while they are at the country club playing golf?

Do you think a medical mal practice suit could be levied against this outfit for maintaining a fruadulant system that is used to forge medical documents such as prescriptions and clinical records?

Good Heavens. I hope this isn't a common practice. :Q

 

[Ylen13]

Originally posted by: shinerburke

Originally posted by: jemcam

How about contacting one of the insurance carriers? They'll look into it, and if there's fraud being perpetrated, they'll investigate. After all, they're the ones that are probably suffering the most.

Well this place deals almost entirely with Medicaid/Medicare. It's a home health agency for the elderly and 99% of their clients are on Medicaid or Medicare. You know how that crap goes as far as fraud is concerned.....I doubt they would even look into it.

My friend is considering calling one of the local television stations and talking to them. I have another friend who is a reporter for one of the stations and I know should would love to get her teeth into something like this. Just not sure that's the correct route to take.

speaking of medical/medicare they don't need any help to defraud them self or to be exact pay money to someone that never build them for it Our company gets check every week and when u call them and tell them about the error they tell u thank you and please it back an it happen all over again next week.After a whille u stop calling them and just send the money back.If the company wanted(owner) probeably could have made good 500,000 just from their errors.

 

[wnied]

if thats the case then I suggest she garner one thing...Proof. Proof of the abuse of the signatures and the book in of itself. Once she has this, a simple call to the states attorneys office is in order.

~wnied~

 

[Ylen13]

Originally posted by: Tripleshot
Another case of abuse of the public trust, and in the medical profession. Why do we pay doctors as much as we do, so they can defraud us while they are at the country club playing golf?

Do you think a medical mal practice suit could be levied against this outfit for maintaining a fruadulant system that is used to forge medical documents such as prescriptions and clinical records?

Good Heavens. I hope this isn't a common practice. :Q

i hate to tell u depends in what medicine industry but yes in someone of the they just pay off doctors with out performing any service and he signed appropriate papers and they make 5 time what they paied him. Sad but true

 

[rufruf44]

Originally posted by: Ylen13

Originally posted by: shinerburke

Originally posted by: jemcam

How about contacting one of the insurance carriers? They'll look into it, and if there's fraud being perpetrated, they'll investigate. After all, they're the ones that are probably suffering the most.

Well this place deals almost entirely with Medicaid/Medicare. It's a home health agency for the elderly and 99% of their clients are on Medicaid or Medicare. You know how that crap goes as far as fraud is concerned.....I doubt they would even look into it.

My friend is considering calling one of the local television stations and talking to them. I have another friend who is a reporter for one of the stations and I know should would love to get her teeth into something like this. Just not sure that's the correct route to take.

Read my respond above, department of health services is the one she should contact off course the local reported can do that for her also.

If she's quitting, can't she contact the Dr's and let them know their signature is being used without consent? I would recommend making copies of the signature's book as well as proof, before reporting to the Health Department though. Dunno if she want to go the distance and record some "conversation" as well in tape.

 

[Tripleshot]

Originally posted by: Ylen13

Originally posted by: Tripleshot
Another case of abuse of the public trust, and in the medical profession. Why do we pay doctors as much as we do, so they can defraud us while they are at the country club playing golf?

Do you think a medical mal practice suit could be levied against this outfit for maintaining a fruadulant system that is used to forge medical documents such as prescriptions and clinical records?

Good Heavens. I hope this isn't a common practice. :Q

i hate to tell u depends in what medicine industry but yes in someone of the they just pay off doctors with out performing any service and he signed appropriate papers and they make 5 time what they paied him. Sad but true

Then this needs to be brought to the attention of lawmakers who have the balls to do the right thing. This is an outrage,and every year healthcare costs go up, and the Reps blame medical mal practice? BS! This is the tip of the iceburg, and medicare,medical fraud should be top of the list. Every doctor guilty of perpetuating rhis fraud should be removed from practice for life. There are good people begging to get into this elite profession. NO MERCY. Drum them out for stealing our money and giving shoddy circumspect service at the same time.

Its time to really clean house in the medical profession. For 30 years I have heard the AMA and medical profession can police themselves,because only they know what is going on and the public wouldn't understand. Well, get a clue, overworked nurses, candy srrippers doaling out meds, shortcuts through out the profession and zero accountabilty ACCEPT to the bottom line. You have to keep the Bean counters happy.

Damnit, I'm on a rant.:disgust: Please forgive me. I have seen alot of abusive practices in my local medical community and this makes my blood boil.