They falsely report OR over-report services rendered to "citizens on Medicaid".
For instance, Ambulance ride. Let's say actual cost of an Ambulance Ride charged by the company is $200. California reports that ambulance ride to the federal government but States it costed them $500. California gets the federal payment for $500, they in turn only pay out $150 to the actual ambulance company, (they never pay full), that's a $350 win for California. Now, multiply that by say 20,000 per year. Now, that is ONLY the ambulance ride.
Hospital care. Patient required Saline by IV. Actual cost of a bag of saline to a Hospital is sub $8. Hospital charges $150 for the bag, $500 for the use of the needles, machine and tubes. Cost of in room care is $600. They report to Medicaid all that crap, $1,250.00 that actually cost the Hospital $20 plus labor. Medicaid pays their part to the state. Hospital gets $400, State keeps the rest. That's ONE PATIENT. Rinse and Repeat.
It's all FRAUD. They use loopholes in order to tag services to Medicaid, computers and algorithms do the rest and whalla.... BILLIONS per year of monies generated thanks to corrupt lawmakers and those that work to bribe them.
Now do Medications!! Holy Shit folks..... Starting to see it yet? $1.00 cost for three days worth of aspirin in hospital can turn into $1,000 if coded property. That's fucking aspirin..... You know, the old $50 roll of toilet paper and $200 Hammer trick.
Once they find a way, they rinse and repeat until BILLIONS of dollars come rolling in.
They falsely report OR over-report services rendered to "citizens on Medicaid".
For instance, Ambulance ride. Let's say actual cost of an Ambulance Ride charged by the company is $200. California reports that ambulance ride to the federal government but States it costed them $500. California gets the federal payment for $500, they in turn only pay out $150 to the actual ambulance company, (they never pay full), that's a $350 win for California. Now, multiply that by say 20,000 per year. Now, that is ONLY the ambulance ride.
Hospital care. Patient required Saline by IV. Actual cost of a bag of saline to a Hospital is sub $8. Hospital charges $150 for the bag, $500 for the use of the needles, machine and tubes. Cost of in room care is $600. They report to Medicaid all that crap, $1,250.00 that actually cost the Hospital $20 plus labor. Medicaid pays their part to the state. Hospital gets $400, State keeps the rest. That's ONE PATIENT. Rinse and Repeat.
It's all FRAUD. They use loopholes in order to tag services to Medicaid, computers and algorithms do the rest and whalla.... BILLIONS per year of monies generated thanks to corrupt lawmakers and those that work to bribe them.
Now do Medications!! Holy Shit folks..... Starting to see it yet? $1.00 cost for three days worth of aspirin in hospital can turn into $1,000 if coded property. That's fucking aspirin..... You know, the old $50 roll of toilet paper and $200 Hammer trick.
Once they find a way, they rinse and repeat until BILLIONS of dollars come rolling in.
✌️ That's How..... ✌️