Wednesday, August 6, 2008

"Red, White and Blue"------- Medicare/Medicaid Fraud on Skid Row

Today,the FBI served search warrants on health care providers operated by Pacific Health Corporation; Tustin Hospital and Medical Center and Los Angeles Doctors Hospital Corporation for Medicare/Medicaid fraud. Apparently the Instituitions used homeless Skid Row residents to defraud Medicare/Medicaid.
The Los Angeles Times has a the details of the story.


I read something recently where a person said, in effect, that the purpose of a writer is to write, not what we know or can write ourselves, but to write what we can not write for ourselves. Keeping in that spirit, I will not write any further about the medicaid scandal news story. I will write about matters relating to it while providing other opinions about the story.

"Red, White and Blue. Red, White and Blue". Those were the first utterances other than "Cavi.Cavi. Weed. Weed" on San Julian Street when I moved into the Marshall House. I had no idea what it meant but it was clear that whatever it was, there was a connection to illegal activity. Unless there was a new drug on the street or a new slang term for an already existing one, it was not drug related. Instinctively, I speculated that it had something to do with fraud. I asked a friend of mine and he confirmed that "Red, White and Blue" referred to the white Medicare card with red and blue strips across it and that it was one of many ways that people were able to make money on Skid Row.

Men stand in front of all of the missions and shout Red, White and Blue every day. They pick up people and drive them, in a van, to a medical facility. They paid a friend of mine one hundred and fifty dollars each time they picked him up he says.
They used his card on several occasions.

My friend is very very smart. He knows how to figure things out. It is his opinion that once they register you at the facility, your card is used many times--not just while you are there but when you are not around. The logic being that it is difficult to track the person. He is homeless and, furthermore, the person is subject to illnesses. Therefore it would not draw too much attention. So provider keeps billing.

Another variation of that scenario, according to my friend who has witnessed this is as follows. They recruit anyone. The person does not have to have a Medicare card. They just need a body. The recruiter already has a Medicare card in their possesion, stolen or acquired from beating a person. The card, gained from the beating, serves as payment for a drug debt.

As I said earlier, hearing "Red,White and Blue" was not the first time I received the signal that criminal activity was alive and well in Skid Row. I wondered into a facility with a new met acquaintance when I first arrived to get some clothes. A woman who worked at the place was very upset. She stated to her superior, in front of several people, that she was tired of seeing her co workers steal clothes donated to homeless people. These clothes would come in every day but the workers would go through them first and take what they wanted first. They clothes would not be taken to be worn by these workers. The person indicated that her fellow workers owned a thrift shop and the clothes taken were used to increase the merchandise inventory for the purpose of selling them to the general public. A year later when I strolled through Skid Row with City of Los Angeles officials and members of the editorial board of the LA Times, another woman ran up to us and made the same claim, that similiar activity was occurring at another facility.

Four months ago, a man, whom I know, walked into the place where I work, to retrieve some mail. He moved out before I began working there and was surprised to see me. I was introduced to him by some of the people in Skid Row who are trying to make a difference. The introduction gave me a certian amount of instant credibility with him and we quickly developed a rapport between us. Our friendship and mutual respect has continued to grow since then.

"Man, you look tired," I said, as he approached the window.
"Yeah, I am. We are having some type of inspection and audit coming up and they are getting the books ready," he responded. "They have me working overtime to help get things ready".
That statement raised an eyebrow so I bluntly asked him a question,
"Are they teaching you how to double count the beds and employ that application in preparing for this inspection as you say?"
There was no hesitation in his answer. "Yes, they are.". He looked at me with this look on his face that seemed to be asking "How could he know?"

Working in the corporate world, one becomes familiar with certain basic office procedures and business practices. When you see things that are a departure from certain accepted practices those activities catch your eye and you store that in a memory bank. The problem is that you see that too many times in Skid Row. They are not isolated incidents.

Skid Row is associated with criminal activity. Perenially, much of that association is linked to drug sales and prostitution. That image of Skid Row serves its purpose in deflecting attention away from those that are making millions in bogus paper trails. That activity is not practiced by the crack street dealers or prostitutes. It is a regular activity of those who sit in office suites far removed from the Skid Row arena.

It does not take much to sense criminal activity on Skid Row. You can smell it. Your instincts pick it up as soon when you land on the 'Row'. It does not take much to figure out what is going on. I tried to write a couple of news organizations once to see if they would give Skid Row more attention than just the ordinary holiday dinner segments. I felt that any one with any street sense could walk around Skid Row and smell that something, many things were array. With good investigative reporting, they might have even won a Pulitzer Prize. But nothing happened.

And then the press conference took place about the Medicare scandal. Sure enough Skid Row was on every ones' mind. I received a call from a City official. He asked me,"Walt, have you heard of anything on the street called 'Orange and Blue'?"I have a reporter on the line and she wants to know." I chuckled when I heard him say that. A reporter, eh. I asked myself if this was what a reporter did. Does a reporter call up a City official after a story comes out, and in doing so, take a "Cliff's Notes" approach to researching stories. Or does a reporter take the lead in investigating issues that need examination and understanding? You can not take the "Cliff's Notes" approach, the short cut in research , in understanding the various elements and issues that are a part of the Skid Row phenomenon. People think that Skid Row is a place. Yes it is.

However Skid Row is more than just a place. The very problems that people have in Skid Row are problems that can be found across America. It is a microcosm of sorts. And like in Skid Row, attention only comes to respective issues after a crisis captures the spotlight in America. A reporter asks a few questions and is satisfied with a few answers, not knowing if the information source is primary or secondary. Furthermore the interests in the issues that gather the spotlight lasts only as long as the ratings allow. That alone perpetuates the media, in some ways, to continue being lagging collectors for information as opposed to leading researchers and entities that provoke thought and necessary change in areas that are vital to the health of America's individual citizens and its collective community.

These pieces of gold that provide knowledge and insights into human behavior and illness are not burried and difficult to find. You can stumble over them on
Skid Row. However to do so news entities must be present. They must be diligent in their dedication to understanding the problems of individuals and by doing so they can understand and explain the problems of America at large to the American family and encourage the powers at be to take steps to cure them, --not a patch work "spotlight reactionary approach" but a methodical approach based on the total understanding of the single elements and components and how they integrate and create devastating outcomes to individuals, families and communities.

Let me give you another example of how many things are not addressed in articles about Skid Row. It was the LAPD who, through the observant eye of its undercover officers, noticed aberrant behavior that began this investigation of fraud. They are often accused of putting the homeless in jail. However no one is giving them credit for discovering this multi million dollar fraud that exploits the homeless. Let us be fair. I might add that in articles and in the broadcast media there was talk about how criminals exploit the homeless. I pose this for thought. The media is not stealing millions of dollars away from the homeless. But I say this. By only reacting to "spotlight" news, are they, in one way or another, realizing it or not, exploiting Skid Row to generate news ratings. I say change this and become a force for change. If Skid Row were more in the watchful eye of those that can keep exploiters and criminals at bay,by exposing the truth, perhaps they could dissuade those from surrendering to the temptation of committing crimes and perpetuating many illnesses that are in Skid Row.

Yes, the exploiters take advantage of those that have drug habits and, yes, they know that a few dollars offered them will be accepted because they will be able to satisfy that jones with the purchase of new drugs. However that is not all of it.
The exploiters take advantage of an attitude or perception, right or wrong of those that feel they have been disenfranchised--that it is ok to get back at the government and rip them off because they are the government, not realizing those tax dollars, ultimately, come from individual citizens. That must be pointed out as well.
All aspects of Skid Row illnesses need to be addressed so that Skid Row can advance toward healthiness. In doing so America can advance as well.

1 comment:

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