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superman Dec 21, 4:12 p.m.
What is the difference being in a hospital bed during the day and being in the hospital at night. You are receiving treatment. So there should be no charge for the bed during the day but it is ok to charge at night. I dont work for a motel or a hospital but I think charging for the bed is reasonable.
superman Dec 21, 9:07 a.m.
If you are in a bed you need to pay. Most motels have gotten away from renting rooms by the hour. Do you have any idea as to the hundreds of people who go to the hospital and cant pay anything? They have to charge enough from the rich in order to care for the poor.
kurtsdollarbill Dec 20, 1:50 p.m.
Bill I guess no one will be punished or fired at Wake Med because you knew what was taken place you crook!! I hope other insurance groups follow and uncover shady billing practices in this hospital. The punishment should be pd by Mr Bill and his high bonus needs to come to a end.
lumberman Dec 20, 1:37 p.m.
Wake Med must be alot like UBS to big to jail. Just get your money back plus some and everything will be ok. But I bet if that was me who stole that kind of money I would be going to jail.
weasel2 Dec 20, 12:27 p.m.
Must be nice to just pay your way out of going to jail.
tran Dec 20, 12:17 p.m.
The moral of the story is if you're going to steal, steal big.
Wake1 Dec 20, 11:25 a.m.
Wonder if other large hospitals are doing the same thing? After all, if it's due to complex Medicare rules, then either the billing folks at other hospitals are smarter or they are doing it too? What say ye Bill??
TomInWakeForest Dec 20, 11:03 a.m.
Another example of no accountability. Isn't it amazing how clearly people see the need to educate differently and administer differently AFTER they are caught doing wrong?! Where was all this clear thinking while the wrongs were being done? Accountability has to live somewhere ... seems pretty hard to find at Wake Med.
norskagent Dec 20, 10:35 a.m.
How else did you expect WakeMed to pay for all those "heart care" and "cancer care" radio and TV ads they are constantly pumping out?
are you kidding me Dec 20, 9:33 a.m.
I am sure it is not a fun house in Accouting...but on the floor you have "slow walkingit."...nurses and cna's for the most part are moving...just do not be in the way when cafetaria opens...plenty of ways to lower costs and cutting ceo wages
lsdhome Dec 20, 9:15 a.m.
If I had presided over such shoddy billing practices in the public agency I headed, I would have been canned within the hour.
itlsss Dec 20, 8:30 a.m.
Mistake my rear! If it was truly random errors there would have been some UNDERCHARGES.
whoodathunk Dec 19, 7:59 p.m.
I've seen WakeMed warehouse an accident patient from the ER with a bogus admission overnight -- and charge $30,000 for it. That was after horrible service, with multiple errors and failure to provide basic care that I could have done better at home with a bottle of peroxide and some bandages. Someone needs to go to prison, not just pay back millions they steal only when they get caught. When are prosecutors going to realize this? Instead prosecutors go after drug possession. They were caught red-handed. Where is justice? What about tax payers and folks who need medical care who won't get it because our society can't afford it due to these cheaters?
rushbot Dec 19, 7:59 p.m.
White collar crime evidently is not too risky, I guess..no jail!!!
soyousay Dec 19, 7:58 p.m.
..The wakemed board..
Has been grromed by Atkinson since he got there. Even with the embarassing public debacle in front of legislature over Rex, even when he single handedly lost Wake Heart...the Board paddles along
rushbot Dec 19, 7:58 p.m.
They should make them give up Rex Hospital as punishment. Sell it to Duke medicine..
northern-transplant Dec 19, 7:53 p.m.
As if their rates weren't ridiculous now (compared to others), you know the patients are the one's that are going to pay for this.
undean Dec 19, 7:34 p.m.
This would be a great opportunity for the WakeMed board to make some changes in upper management to help restore the public's confidence and move in a new direction. If people KNEW about the fraud and did nothing, they should be sacked. If they DIDN'T know they obviously weren't minding the store, and should be sacked anyway. Seems like this level of fine is too severe to continue with business as usual. Otherwise, it's only a matter of time until the next investigation.
Rebelyell55 Dec 19, 7:17 p.m.
As someone menition, they take in those who have no insurance or medicare or medicaid. so they justified what they do to cover those cost. Which just happen to be the same excuse they use for charging some 35.00 for an asprin.
undean Dec 19, 7:07 p.m.
This is a black mark on what used to be one of the best hospitals in the state. I left to work for another facility because it seemed like the administration was becoming too focused on cutting corners and quick fix solutions. You can bet Ray Champ would've never let this go on as long as it did.
soyousay Dec 19, 6:57 p.m.
The information is straight from the settlement..they were falsifying MD orders to squeeze another buck Management knew it and by their own admission so did the execs. Who cares how sm.all a per,centage they "seetled to pay for...how much did they cost the taxpayers..how about insurers?
jrfergerson Dec 19, 6:54 p.m.
This is just about as bad a the EMS service that takes a round about trip (the long route) to take a patient to the hospital. From our home it is 12 miles to the nearest hospital. yet as I followed the EMS vehicle to the hospital I thought why are they takeing a route that is 26 miles. I found out when the bill came. THEY BILL THE PATIENT PER MILE FOR THE TRIP. What a bunch of thieves.
The Last Basselope Dec 19, 6:40 p.m.
Where do you people get your information?! Let's look at this reasonably...$8 million over, more than likely, a several year period. WakeMed is a $1 BILLION per year healthcare system. That means the error rate is likely 0.4% over a two year period. Anyone who has dealt with Medicare billing knows the ambiguities in the regulations. If Medicare wants to stop "errors" in billing, they need to clearly define inpatient verses outpatient services. The regulations do not have a clear definition. How many people realize Medicare patients have to pay a larger portion of the bill if they are an outpatient?
To those that say WakeMed should be prohibited from serving Medicare/Government patients...WakeMed, and other hospitals, would benefit from that. Fact is, Hospitals lose money on Medicare patients, unfortunate as that is.
By the way, to the person who stated Rex Healthcare does not accept Medicare patients unless you go to the ED, you couldn't be further from the truth.
flack222 Dec 19, 6:35 p.m.
I'm sure they were hoping to pay for that helicopter/lawn ornament they have sitting there out front.
soyousay Dec 19, 6:17 p.m.
Luv...you missed the poiint entirely..
They falsified ordered. They billed for beds that were empty..it wasn't the slip of a key stroke. Mangers knew..you bet after the subpoenas....yes subpoenas....read the article ..they were in full damage control mode
King of Ignorance Dec 19, 6:15 p.m.
"Some mistakes were made.... luvbailey"
Not according to Wake Med and the US Attorney. Wake Med admitting being guilty of Medicare fraud. That's not a mistake. It's criminal activity, hence the US Attorney's involvement.
Rebelyell55 Dec 19, 6:09 p.m.
Since they are settling for this amount, it pretty good bet they did something wrong and knew about it. The hospital in Southern Pine is just as bad. They sent out billing knowing they're not suppose too. But if they get extra money, they keep trying, because I'm sure there are older folks who pay it. It'a calculated risk that most HMO are doing.
King of Ignorance Dec 19, 6:06 p.m.
The article states: "Investigators said WakeMed routinely billed Medicare for inpatient stays by people who had undergone cardiac treatments, even if they were discharged the same day as the treatment and never spent a night in the Raleigh hospital. Physician orders to discharge patients also were frequently overwritten so Medicare could be billed, according to federal court documents."
That, ladies and gentlemen, is fraud. They intentionally changed discharge orders to make outpatient visits look like inpatients. That doesn't sound like a mistake to me.
In my opinion, ti is willful. The clear intent was to steal from Medicare.
I don't want to hear excuses about the complexity of billing. It's irrelevant. They willfully manipulated visits to get charge higher rates. The fact nobody is going to prison is outrageous.
Walkin Man Dec 19, 6:05 p.m.
If this hospital is doing it, you can bet there are a lot more of them out there. If they want to keep the costs of Medicare down, start with providers and hospitals who over bill.
luvbailey Dec 19, 6:05 p.m.
I have one thing to say to all you people calling for jail time, greater fines, and barring Wake Med from future Medicare work: GET REAL. Wake Med is a giant operation. They serve thousand of patients each year and process hundreds of thousands of transactions (codings). Some mistakes were made. The mistakes have been found, acknowledged and monetary renumeration, including significant penalties, have been paid. Additional training to prevent this in the future had been set up. So as Barney would say, "All right people, nothing to see here, let's move on."
soyousay Dec 19, 5:48 p.m.
Esser you are wro g. Doctors admit to hospital....and a hospital doesnT redirect at that point. EDs take medicare.. EVERY hospital that even takes a whiff of federal money takes Medicare
sunshine1040 Dec 19, 5:47 p.m.
At the least it gave a few people jobs the auditors and investigators Now unless potential fraud they will be standing down at the unemployment lines
Dynol Yn Cael Ei Dec 19, 5:33 p.m.
larieke - "Esser Huma, boy are you misinformed. ALL hospitals in the area take Medicare patients."
Have you tried it yet?
Rex will only take a Medicare patient if it's an emergency situation. Otherwise, they point you towards the nearest WakeMed facility.
Dynol Yn Cael Ei Dec 19, 5:32 p.m.
rachel - "its a very interesting game dealing with the government-the reimbursement is awful and the codes and amounts paid change constantly, plus after they change the rules, they can back and edit you based on the new changes-so it's real easy to run afoul of the government..."
I work at a grocery store, and we see that on a very small scale with WIC - what a person can buy one week is suddenly verbotten the next. It's hard to keep up with, so I can fully understand.
However, if someone somewhere can prove intention to fraud, someone should be sitting in a FEDERAL jail thumbing through a phone book for a good attorney.
soyousay Dec 19, 5:05 p.m.
They help the needy...
Cry us a river..they don't if they can help it...he closed the clinics that did. Oh and do you know how much he makes "helping" the needy
larieke Dec 19, 5:04 p.m.
"They're about the only hospital in the area that will take elderly Medicare patients, so I'm not for that idea at all.-Esser Huma"
Esser Huma, boy are you misinformed. ALL hospitals in the area take Medicare patients.
soyousay Dec 19, 5:02 p.m.
Not defending them....
Then don't. They knew excatly what they were doing. If "overwriting" MD orders was policy then this endemic and a whole lot more than medicare fruad. Atkinson should finally go. The insurance companies don't get to investigate like this and you can bet they were gouged too. Any surpise Wake Heart didn't want to deal with him!
soyousay Dec 19, 4:57 p.m.
Atkinson stacked the Board over the last few years. He AND his exec team and the CFO will keep their jobs and bonuses
rhess2 Dec 19, 4:56 p.m.
The Medicare billing fraud at Wake Med didn't just happen by osmosis. There had to be administrator(s) and/or employees involved. Yet nobody working at the Hospital was prosecuted or fired. If I were the president and chief executive at Wake Med I most certainly would want to know and fire those involved. Of course, unless I myself was involved.
rachel Dec 19, 4:56 p.m.
its a very interesting game dealing with the government-the reimbursement is awful and the codes and amounts paid change constantly, plus after they change the rules, they can back and edit you based on the new changes-so it's real easy to run afoul of the government-the CEO has to take responsibility for the mistakes, its part of his job-it doesn't mean he ordered or abetted the billing department making mistakes-
Thought Criminal WS Dec 19, 4:55 p.m.
I don't see anyone in the comments NOR in the article point something out... this is how MOST hospitals manage the cost of those without or under insured who NEED treatment. They bill the previous patient and passed the services on to the needy. It's a wink wink nudge nudge situation - what Obamacare is SUPPOSED to address (but doesn't).
No one will see jail time because they do this to HELP the needy and the POOR. People put themselves at risk to help others, which is why a BLIND EYE will be turned. There is no benefit to the people committing the fraud other than helping others in need.
If you think WakeMed is the only place this happens, you're in unicorn land. EVERY hospital does this on some level or another, be it "wasting" meds or mistakes that open services to others.
Now ask, who gets the $$$ from the fine?
notanutcase Dec 19, 4:41 p.m.
rlsmith - "They should lose ability to do government service for two to three years at least."
They're about the only hospital in the area that will take elderly Medicare patients, so I'm not for that idea at all.
Not defending them but they do a stupendous amount of charity care for the elderly patients and for the uninsured. Billing is very tedious thanks to the way different codes are changing constantly. WakeMed does not set those codes, the insurance company does and those codes are extremely confusing and to try to get an accurate answer from any insurance company is even worse. Insurance companies pass the buck and if their employees give inaccurate coding information that is where the problem possibly starts. Go ahead complain, but when you need someone to take care of you I'm sure I will see you sitting at WakeMed somewhere!
blisstate Dec 19, 4:29 p.m.
Wait, how is it possible Dr. Bill Atkinson keeps his job when he knowingly and willing admits fraud under his watch?
superman Dec 19, 4:21 p.m.
Please just take a moment and try to think who would have benefited from the charges.
SmokeWagon Dec 19, 4:20 p.m.
..."I hope someone goes to jail for this misuse of funds - but I doubt it!!..."
Naaaah, don't bet on it...heck, yesterday a judge got a slap on the wrist for fraud, you actually think these rich people will get jail time....??????
SmokeWagon Dec 19, 4:17 p.m.
...“We always strive to submit accurate, compliant bills to patients, insurance companies, Medicaid and Medicare,” Dr. Bill Atkinson, WakeMed president and chief executive, said..."
Well @ $8 MILLION bucks doesn't seem as if your "striving" department is quite up to snuff....!!!!!...Wonder HOW MANY patients get OVERCHARGED and then have their bills sent to collections because they can't pay the bogus bills......????????
davidk_at_unc Dec 19, 4:12 p.m.
"They should be able to charge for a bed if they in the hospital whether they spend the night or not. They were there in a bed." -- superman
Wrong, as usual. They weren't charged for a "bed", they were charged for "inpatient services", i.e. an overnight stay. Besides, where in the article does it say they were "in a bed"? I must of missed that part. Did they ever lie down during their visit? Most likely ... either in an OR or a recovery room, but I can pretty much guarantee you that WakeMed billed them for that already. You continue to amaze me!
radium Dec 19, 4:06 p.m.
Yea, they'll fix the problem by doing a better job of hiding their crimes, they won't change.
proverbial Dec 19, 4:06 p.m.
And for those who say the hospital should lose the "ability" to do govt services....they would love to! Medicare and Medicaid often do not reimburse enough to even cover cost! Hospitals are not simply permitted to see these patients, but are REQUIRED to see these patients.
radium Dec 19, 4:05 p.m.
And I will bet you a trillion dollars that those that ran this fraud are the staunchest enemies of Obama, want Medicare and Social security destroyed and voted Romney. Just like all the Republican governors that scream budget cuts while holding their arms open for the boat loads of cash they get from the "evil" Obama and his "socialist" government. The hypocrisy is unreal.
Published: 2008-01-11 14:37:00
Updated: 2010-06-21 13:53:03