Medicare Fraud? You tell me.
In 2006 I was diagnosed with severe sleep apnea and received a prescription for an oxygen concentrator. Like a good patient I contacted Pacific Pulmonary, one of several companies providing medical devices.
They delivered a Respironics EverFlo-Q Oxygen Concentrator and a supply of Salter Labs Nasal Cannulas. For use of this equipment, Pacific Pulmonary has billed Humana, my insurer, about $121 per month, and they have billed me a co-pay of $24 a month. It has been a total of about 60 months, but Pacific Pulmonary claims there were 15 months during which they did not bill.
I am not very good at remembering due dates or payment details, so I leave that to my wife of forty years. She is generally quite frugal, extremely good at meeting all obligation dates and amounts and is good at arithmetic. Perhaps Pacific Pulmonary has billed us only 45 months... I'll take their word for it pending further checking.
In any event, 45 months at about $145 a month, totals over $6,700. During this period, they have sent perhaps an additional 50 nasal cannulas.
Humana has advised that they will no longer pay for Pacific Pulmonary services, and has advised we contact a different provider. This prompted me to add up what we have paid Pacific and what they have provided.
I Googled "Respironic oxygen concentrator" and was instantly provided with the URL of several providers. I clicked on one, http://www.portablenebs.com and learned that the Respironics unit I am using is available for purchase for $599; nasal cannulas are about $12.50 for 10.
To summarize, Pacific Pulmonary has "rented" me a piece of gear worth $600 and tossed in about $75 worth of accessories, for the amazing low price of just $6,700!
Gee, what a business!
Is it legal? Probably. I signed whatever paperwork was presented me.
Is it fraud? In my opinion, decidedly yes! How about you?
Saturday, July 23, 2011
Tuesday, July 5, 2011
The Legacy of New Mexico Democrats
My adopted state of New Mexico is a shining example of how the Democrat Party shapes any governmental unit they dominate.
Democrats have held the majority in almost every city, county, state or federal office. In November, 2010, we elected a Republican governor; broke the Democrats hold on our congressional delegation by electing a Republican to one of our three districts, and we gained some seats in our state legislature. But Democrats still hold majorities.
What is the result: Here is how the American Society of Civil Engineers graded New Mexico's infrastructure:
1. Aviation: D
2. Bridges: C
3. Dams: D
4. Drinking Water: D-
5. Energy: D+
6. Hazardous Waste: D
7. Inland Waterways: D-
8. Levees: D-
9. Public Parks and recreation: C-
10. Rail: C-
11. Roads: D-
12: Schools: D
13. Solid Waste: C+
14. Transit: D
15. Wastewater: D-
Meantime, New Mexico's Department of Higher Education reports that, for the fist time in history, New Mexico's older residents are better educated than its younger ones. A higher percentage of those 45 to 65 years old have an associate's degree or higher compared to those who are 25 to 44. In other words, our system of higher education is no longer working.
New Mexico has a variety of climates, from toasty warm deserts to cool mountains. It has an abundance of natural resources, including oil, natural gas and uranium. It has fishing, big and small game hunting; lakes, ski areas and other tourist attractions. And, New Mexico has spectacular scenery and breathtaking sunsets nearly every day.
New Mexico now has a commercial spaceport. (It costs a lot less to launch from 4,000 feet than at sea level, as in Florida.)
There is every reason why New Mexico should be a thriving, prosperous state. Sadly, its management - its government - has prevented that from becoming a reality.
My adopted state of New Mexico is a shining example of how the Democrat Party shapes any governmental unit they dominate.
Democrats have held the majority in almost every city, county, state or federal office. In November, 2010, we elected a Republican governor; broke the Democrats hold on our congressional delegation by electing a Republican to one of our three districts, and we gained some seats in our state legislature. But Democrats still hold majorities.
What is the result: Here is how the American Society of Civil Engineers graded New Mexico's infrastructure:
1. Aviation: D
2. Bridges: C
3. Dams: D
4. Drinking Water: D-
5. Energy: D+
6. Hazardous Waste: D
7. Inland Waterways: D-
8. Levees: D-
9. Public Parks and recreation: C-
10. Rail: C-
11. Roads: D-
12: Schools: D
13. Solid Waste: C+
14. Transit: D
15. Wastewater: D-
Meantime, New Mexico's Department of Higher Education reports that, for the fist time in history, New Mexico's older residents are better educated than its younger ones. A higher percentage of those 45 to 65 years old have an associate's degree or higher compared to those who are 25 to 44. In other words, our system of higher education is no longer working.
New Mexico has a variety of climates, from toasty warm deserts to cool mountains. It has an abundance of natural resources, including oil, natural gas and uranium. It has fishing, big and small game hunting; lakes, ski areas and other tourist attractions. And, New Mexico has spectacular scenery and breathtaking sunsets nearly every day.
New Mexico now has a commercial spaceport. (It costs a lot less to launch from 4,000 feet than at sea level, as in Florida.)
There is every reason why New Mexico should be a thriving, prosperous state. Sadly, its management - its government - has prevented that from becoming a reality.
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