03 June 2013
An hour-plus commute to LAX (Los Angeles International Airport) would give anyone back problems, let alone the umpteen-hour flight. For some lucky scoliosis-suffers and frequent-fliers, prayers were answered when the famous acupuncturist from Los Angeles arrived over the weekend. Unfortunately he was immediately incarcerated for Medicare fraud of over $2.1 million.
Won Suk Lee of Won Suk Lee Acupuncture and Herb, Inc. in Huntington Park, a suburb of Los Angeles, felt the hot needle of the law pierce his freedom when stepping off a plane from South Korea Saturday morning. FBI kindly reminded him that he'd been on their Most Wanted List since 2011 and charged with billing Medicare for procedures they don't cover, including acupuncture and massages through 2009-11. Lee thought he could slip through the cracks by referring to these procedures as physical therapy in his clinic and escaping to South Korea upon his arrest warrant. Agents Mulder and Scully proved him wrong.
Much like animals with fraudulent diplomas, Medicare fraud is apparently so common in this country it has its own Wikipedia page. Lucky for Kitty O'Malley, who contrary to Floridian belief did not graduate high school, Obamacare targets only humans involved in fraud with its newly-created Health Care Fraud Protection/Enforcement Action Team (HEAT). In 2013's budget, the Department of Health and Human Services requested $294.5 million in funding to aid this task force, which in its first year of 2011 recouped $115 million in Medicare fraud.
Before even signing Obamacare (Affordable Care Act) into law in 2010, President Obama cracked down on medical malfeances at the first National Summit of Health Care Fraud, an unprecedented partnership between law enforcement, private and public sector, and government officials. Due to a combination of anti-fraud enforcement teams, Obamacare regulations, and additional funding the government recovered over $14.9 billion in Medicare waste in President Obama's first 4 years in office. To put it into perspective, in George W. Bush's last 4 years only $6.7 billion were reclaimed.
The FBI estimates anywhere between $75 billion and $250 billion in Medicare fraud occurs in this country annually, accounting for 3-10% of the program's spending. Originally set up for doctors who helped the needy, Medicare billing is based on the honor system. As any unlucky trick-or-treater who stumbles upon a unguarded and empty candy bowl at someone's doorstep can attest, the honor system is broken. Obamacare continues to prevent fraudulent activity by scrutinizing irregular billing patterns (i.e.: vision billing at a dentist's office), training officers in compliance and audits, and mandating doctors return overpayments in 60 days.
Medicare waste reduction will help one of the most important phases of Obamacare, the Exchanges, succeed by saving tax dollars for those who need health insurance the most. On October 1st, 2013, the Exchanges (in California it's Covered California) begin open enrollment for benefits which begin on New Years. Plans offered through the Exchange include Essential Health Benefits and the opportunity to receive tax credits (subsidies) to help lower the cost for health insurance, as mandated by Obamacare.
There are still 170 Medicare fraud fugitives on the Most Wanted List. If you see them, call the FBI immediately. If you're just curious about health insurance, call us at 818.251.5000!