editor, Author at Monitor Telegram

Former RCMP Officer Comments on Healthcare Fraud

August 10, 2017

There are a few people in this country concerned about misuse of healthcare funds even though our governments apparently aren’t.

One such individual is a former RCMP officer by the name of John Robert Lyons. Per his profile on LinkedIn, he was a peace officer with the RCMP for 27 years and prior to his retirement from public service was a fraud risk consultant with the Ontario Ministry of Health and Long-Term Care.

He, with a partner from the United States, now operates The ATRiM Group LLC, a company which provides “services assisting the health care sector deliver counter-fraud training and strategies based in crime prevention science.”

Lyons provided the Monitor Telegram with a copy of a paper he has published on healthcare fraud in Canada. So we are providing it here for our readers.

[pdf-embedder url=”https://https://monitortelegram.com/wp-content/uploads/2017/08/HCSWhilePaper28final29.pdf” title=”_HCS+While+Paper+final”]

Arnprior doctor, hospital sued in $5-million malpractice claim

August 8, 2017

When Ray Nicholas noticed a bump on his stomach, he went to see his family doctor and was advised it was likely a hernia, and that there was no need for treatment.

A month later, in July 2015, he returned to the doctor, complaining of pain. He says he was told to keep rubbing and pushing it in to alleviate the discomfort.

No medication prescribed, no referral to a specialist.

A month after that, Nicholas needed life-saving surgery.

Canada Just Can’t Quit Its Most Abusive Mining Company

August 8, 2017

Will the Canadian government continue to support Barrick Gold’s exploitation of mineral resources in Tanzania no matter what abuses the company commits?

Would the Trudeau government stop backing the Toronto-based firm if it bilked the impoverished nation out of $10 billion? Or, what if one thousand people were raped and seriously injured by Barrick security? Would Ottawa withdraw its support if one hundred Tanzanians were killed at its mines?

Psych center employee charged with abuse, fraud

August 8, 2017

MARCY — An employee at the Central New York Psychiatric Center has been charged with defrauding Workers’ Compensation after law enforcement officials said he was caught kayaking on a Caribbean vacation.

Ryan P. Haley, 30, of Rome, unlawfully received more than $2,500 from the state Workers’ Compensation while on pre-planned vacations to Puerto Rico and California, according to the state Inspector General. Haley also physically harassed a Psych Center patient after he returned to work, officials said.

Haley is a security hospital treatment assistant at the Pysch Center, officials said.

Toilet paper limited to ‘two per week’ at New Brunswick retirement home

August 8, 2017

MONCTON, N.B. — Residents of a New Brunswick seniors’ home have been informed they will each be limited to two rolls of toilet paper a week.

The Manoir Notre-Dame in Moncton said in a written notice the move is necessary because of an increase in overall costs.

“We will limit the rolls of toilet paper to two per week which will be deposited every Monday in the rooms,” the Aug. 2 notice read.

Washington Declares War on Opioid Epidemic, Fraudulent Doctors

August 7, 2017

The US war on the opioid epidemic is heating up, with 3 recent noteworthy developments.

On July 31, Chris Christie, chair of the President’s Commission on Combating Drug Addiction and the Opioid Crisis, issued his interim report, calling the recommendation to declare the opioid epidemic a national emergency the most important of all. (Among the other recommendations: mandating physician education, increasing availability of the overdose reversal agent naloxone).¹

Leaders of $374 Million Home Health Care Fraud Denied Acquittal

August 7, 2017

After being sentenced for participation in a $374 million home heath care fraud scheme, two home health agency owners and a Dallas-area doctor have been denied acquittal.

Jacques Roy, M.C., 59; Cynthia Stiger, 54; and Charity Eleda, 56, were convicted on one count of conspiracy to commit health care fraud. Roy was also convicted on eight counts of health care fraud, and Eleda on four counts.

Insurers Think They’ve Found the Perfect Patients for Profits

August 4, 2017

The turmoil around the Affordable Care Act has created heartburn for health insurers. The industry is betting that a different government program will soothe its ills.

Big insurers have retreated from Obamacare’s individual market, where fighting over the future of the health law has contributed to financial losses. They’re focusing instead on Medicare Advantage, a politically popular program that’s being embraced by a growing population of older Americans.

Inpatient psychiatric facilities get $45 million raise from Medicare

August 3, 2017

The CMS will give inpatient psychiatric facilities a modest 1% Medicaid reimbursement increase next year of $45 million.

That’s less than half of the 2.2%, $100 million increase in Medicare reimbursement they received this fiscal year.

The agency made the change via a notice rather than a rulemaking on Wednesday, and will not accept comments on the decision. The CMS said rulemaking was unnecessary because the updates don’t reflect any “substantive” changes in policy.

Hoskins will ‘express concerns’ about patient record software being used to sell drugs

August 3, 2017

Concerned for patients’ privacy and pocketbooks, Ontario’s health minister says he will tackle a new Big Pharma marketing scheme that uses electronic medical records to sell drugs.

Minister Eric Hoskins said he will ask Ontario’s College of Physicians and Surgeons to investigate how electronic vouchers that steer patients to brand name drugs over cheaper generics “may be impacting privacy, accessibility and affordability.”

He said he also plans to “express my concerns” with Telus Health, which inserts the electronic vouchers into its popular electronic medical record software (EMR) used by thousands of doctors across Canada.