32597944 - surgical life

Shortcuts can help you be more productive. For example, using shortcuts or combining a couple of keystrokes on your computer keyboard can help you throw together an important presentation in no time at all. Or, using a traffic app on your mobile phone can direct you to a shortcut that avoids traffic jams on your way to work. But, taking a shortcut can be a bad thing. A Houston, Texas doctor and others settled allegations of Medicare fraud after performing shortcuts during colonoscopies for Medicare patients.

I probably don’t have to tell you why it’s important to have a colonoscopy performed, but it doesn’t hurt to remind you of a few facts. Colorectal cancer is the third most common cancer among both men and women in the United States, and it occurs most often in individuals older than 50. Screenings can prevent colorectal cancers by finding abnormal growths in the colon that doctors can remove. (But, it’s important for you to know that colons are typically about five feet long. So, you can see how taking a short cut in an exam might miss something important.)

An investigation into the Houston, Texas doctor and other doctors who worked at two practices and a surgical center in the area was opened after an endoscopy nurse formerly employed by the surgical center claimed that the doctors would take short cuts while performing colonoscopies. (Some of the screenings only lasted about two minutes. Think of all the precancerous lesions that could have been missed, putting the Medicare patients at risk.)

And, that’s not all. Apparently, the nurse alleged that the surgery center had poor sanitation procedures. (That’s so gross I don’t even want to think about it.) To save money, she claimed that the doctors did not put on a clean gown prior to each surgery. (How can you compare the cost of an extra load of laundry to what someone’s life is worth?) As you might guess, the nurse was fired the day after she complained to the surgery center’s regional vice president.

The Houston doctor and other involved doctors reached an agreement with the government concerning their North Houston surgery center that performed quick colonoscopies over seven-and-a-half years. (The doctors consistently and repeatedly denied the allegations against them.) The agreement involved paying $1,575,000 to settle allegations of Medicare fraud.

Ironically, the defendant’s lawyer said that the “settlement was made solely to avoid the cost of defending the allegations and to continue to serve the community with the highest quality of care and standards as they have done for the last three decades.” (Really? He must have a totally different idea of what constitutes high standards.)

Medicare expects medical providers to follow established medical standards of care and sanitation when performing any medical procedure. If you ask me, by settling, it looks like this medical provider took another shortcut and avoided having to pay even more money out of pocket. (His shortcut allowed him to avoid the long route to jail.)

Today’s “Fraud of the Day” is based on an article entitled, Former medical society prez settle Medicare fraud charges,” published by Houston Chronicle on November 21, 2017.

A former president of the Harris County Medical Society and his diagnostic and surgical center have agreed to pay more than $1.5 million to settle allegations of Medicare fraud.

The U.S. Department of Justice on Wednesday announced the agreement, which concerns allegations that Dr. Gurunath Thota Reddy and other doctors at Memorial Hermann Endoscopy and Surgery Center in North Houston over a 7½-year period performed colonoscopies so quickly that they were “essentially worthless.”

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Larry Benson, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.