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Addressing The White House Conference on Aging in May 1995, President Clinton called for a crackdown on Medicare fraud. Citing such abuses as the doctor who bills for simply looking in the door of the patient’s room or the equipment vendor who charges inflated prices for durable equipment, Clinton promised to set up task forces to aggressively fight Medicare fraud.
These fraud-fighting task forces will be composed of insurance company executives, state investigators and federal inspectors. The campaign will focus on five states—California, Florida, Illinois, New York and Texas—which are home to approximately 40 percent of the nation’s Medicare recipients. The main targets will be durable medical equipment sales, home health care providers and nursing homes.
Clinton cited a projected return of $6 to $8 for every $1 spent by the government. He called the program a “win-win situation” for everyone except those perpetrating the frauds. “And it’s about time they lost one,” he said.
Lift that Lid…
Trim that Tail…
Tuck that Tummy…
Go to Jail!
“Clinique Cam Thach”, a Westminster, CA, cosmetic surgery clinic, was run by Elizabeth Cam Thach Thi Le. The clinic did big business by staying open until late at night and by placing ads in Vietnamese newspapers, offering low-cost surgery performed by American doctors.
Recently, however, Le and two doctors who worked at the clinic were found guilty of insurance fraud and grand theft. Le was convicted of seven counts of insurance fraud and two counts of grand theft; Dr. Alexander Sinclair was convicted of four counts of insurance fraud and two counts of grand theft; Dr. David Page was convicted of five counts of insurance fraud.
Le and Sinclair could both be facing ten-year prison terms on March 1, 1995, when the judge hands down the sentences. Page faces the possibility of a nine-year term.
The convictions stem from charges that the clinic billed insurance companies for medically necessary procedures when the surgical procedures actually performed were merely cosmetic. Additionally, those procedures for which there was a medical purpose were over-billed to the insurance companies.
Investigation revealed that the clinic often stayed open as late as 2 a.m. and billed as much as $100,000 in a single day.
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