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The link between healthcare fraud and elder abuse


Senior scams aren't just about conning the elderly out of their life savings; there's also a connection between elder abuse and healthcare fraud.

When a nursing facility, for example, mistreats an insured patient and then claims payment for services involved, "the same conduct amounts to nursing home fraud on the government and is a particularly lethal form of elder abuse," according to a San Francisco Injury Lawyer blog post. 

Case in point: Two California nursing homes face healthcare fraud charges for jeopardizing the health of facility residents, the blog post noted. Managed by Arba Group, these facilities stand accused of overmedicating patients "for the convenience of management."  

One man received antipsychotic drugs for which there were no doctor's orders and without the consent of himself or his family, the complaint alleges. He was later hospitalized for problems including heart failure, sepsis and an infected pressure ulcer. Arba violated the False Claims Act by billing Medicare and Medicaid for "non-existent, grossly inadequate, materially substandard and/or worthless services," the complaint alleges. The company denies all charges, the blog post added.

Meanwhile in Tennessee, Jack Carl Riggins reportedly swiped a woman's savings so Medicaid would pay for her nursing home care, WTVC News reported

Riggins is accused of transferring an elderly woman's assets to himself through a durable power of attorney, the station noted. That made her eligible for the state's Medicaid program, known as TennCare. But this type of "pauperizing" to receive long-term healthcare on the government's tab violates federal law, the article noted. Riggins faces charges of TennCare fraud, theft of services over $80,000 and elder abuse.

To help decrease financial and other exploitation of the elderly, the U.S. Department of Justice launched a website for prosecutors, researchers and victims. This website "marks another milestone in reaching the shared goal of keeping older Americans safe from abuse and neglect," Associate Attorney General Tony West told the Wisconsin Senior Medicare Patrol.

For more:
- read the San Francisco Injury Lawyer blog post
- here's the WTVC News article
- see the Wisconsin Senior Medicare Patrol article

Related Articles:
States shift nursing home residents into Medicaid managed care
Geriatrician: Eliminate Medicare's 3-night rule
Nursing homes offer solution to curb hospital readmissions
Nursing homes have high readmission rates
Hospices, nursing facilities must report quality data or lose Medicare dollars
More long-term-care patients join managed care plans