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Why your doctor is going out of business (must read!)
Infinitelove Views: 1,567
Published: 14 years ago

Why your doctor is going out of business (must read!)

As much as I'd like to take credit for this post, it was NOT composed by me but by the poster Azurite:


I used to think Big Pharma was this country’s biggest threat to your health. I no longer believe that. Yes, pharmaceutical drugs kill and maim tens of thousands of people every year. But there’s a new threat to your health that’s far more dangerous and insidious.

This threat doesn’t attack individual patients the way drugs and diseases do. Instead, it attacks doctors. You read that right! This menace now has the livelihoods of America’s physicians in its grasp.

And it’s not just alternative doctors that are threatened. Every doctor in this country is at risk — conventional and alternative alike. Many will end up in jail. Others will lose their license, their practice, and their reputation. Still others will end up bankrupt and in ruins.

Obviously, this threat isn’t a disease, though some might argue differently. It’s a relatively new set of laws that has put your doctor in the crosshairs. Let me explain:

Thirteen years ago, Bill and Hillary Clinton tried to create one universal health system — under the government. It was essentially cookbook medicine, written and controlled at every level by government.

Very quickly, the public awakened. The American people realized that with the Clinton program, government would dictate what diseases and the treatments you were allowed to have. So the Clinton’s program bit the dust — hard.

But the Clinton’s weren’t about to let it die. Key provisions of the original plan were encoded into a new law. In 1996, Congress passed the Health Insurance Portability and Accountability Act (HIPAA). On the surface, this law seems like a great idea. It made it far easier to change from one insurance carrier to another. Pre-existing conditions couldn’t prevent the transfer.

But hidden in the bill were a mountain of new health care laws. Under these laws, your doctor commits a Federal crime if he violates or conspires to violate any of the nine criminal statutes or commits any of the four crimes the act establishes. That sounds appropriate enough, until you realize what it takes to break these laws.

All your doctor (or any health practitioner for that matter, including chiropractors) has to do is make a clerical error. You know, all the numbers that come on your bill. If even one of those numbers is wrong, it is now cause for an audit from the U.S. government.

But that’s just the beginning. The bill also funded an army of new law-enforcement agents, who were commissioned to investigate this new class of “health care”’ criminals. So when your doctor’s office makes a clerical error, agents will walk into your doctor’s office and look at as many billing files as they want. Usually, the agents will focus on a small percentage of the files, looking for more clerical errors. From these mistakes, they estimate how much a doctor has overbilled for his entire practice.

It gets worse. Once the agents find out how much a doctor has “overbilled,” they can then assess a penalty as great as three times the amount of the mistakes. And if the agents are really after him, he can be indicted for fraud, embezzlement, false statements, and obstruction. All over clerical errors.

Under these draconian laws, anyone who defrauds any health benefit program faces imprisonment up to 10 years and a fine up to $250,000. If there is injury to the patient, the doctor can be imprisoned for 20 years. There is a provision making it a Federal crime to make false statements in connection with health care delivery. There is a penalty for “incorrect coding or medically unnecessary” services. Conviction of such an offense can lead to more charges. After all, if your doctor is co-mingling funds earned from Medicare into the regular practice account, that could be called money laundering.

For doctors and other health care practitioners, this is a no-win situation. That’s because they must follow 132,720 pages of federal health care rules and regulations, with 111,000 covering Medicare. Physicians get lost in the fog of these regulations.

Now assume that your doctor is a genius and can read 100 pages of the 132,720 pages of regulations each day. Assume that he can retain all the information. It will take him 3.6 years to read them all. He could be a criminal long before he got to the end.

Doctors often have to choose between reading all the regulations and treating patients. There’s just no way to do both. Most of the time, physicians have no idea whether or not Medicare will pay for services until after the fact. They’ll have to hire new staff to protect the practice from the investigators. And guess who ends up paying for all this in the end? These laws will end up adding as much as 40% to your total “health” bill. If they bill for it and it’s not covered, they’ve committed a felony!

Under HIPAA, I can assure you that in the course of one day, your doctor will have committed several infractions. These could include rendering care that some regulator won’t approve of. Or perhaps he honestly billed you for his total therapeutic time when federal guidelines prescribe that he should have booted you out 10 minutes before your needs were met. He could even be a criminal for giving you vitamin C for your cold.

Now consider this example. You ask your doctor for a stool test for blood as a screen for colon cancer, but have no symptoms. It’s positive. It’s caught in time and your life is saved. However, your doctor billed Medicare for a preventive service, which to Medicare is fraud. The absence of intent to cheat Medicare doesn’t matter. Your doctor gets fined up to $10,000 (or jailed) for ordering the test even when he had no personal profit from the lab test.

The laws are so confusing even Medicare bureaucrats struggle to define the meaning of “medically improper or necessary health care services.” The ultimate decision rests with people hundreds or thousands of miles away from your encounter with your doctor.

According to the Cato Institute, one physician did not think a service would be covered and told his patient the same. But program administrators told him the service would be covered. He was soon paid, but officials LATER changed their minds. He was required to reimburse Medicare. He complained and soon found federal investigators in his office auditing his entire practice.

This creates an impossible “twilight zone” for conscientious providers according to Florida dermatologist Dr. Philip Catalano.

Just look at this idiocy:

Dr. Catalano said, “HCFA (Health Care Financing Administration) has decided that only a limited number of actinic keratosis (pre-cancerous skin lesions) can be frozen within a given period of time. You may have severe sun damage and have the upper limit removed (now 15 on a single day). You come back in a few months with another lesion and Medicare can reject payment as exceeding the imposed limits.” And if doctors exceed those limits, they can be fined or arrested.

What’s worse, Medicare forbids you to privately contract with your doctor to remove the lesions even if paid for by you. Your doctor would have to get out of the Medicare program for at least two years to accept a penny in direct payment from you.

I hope this makes you as angry as it does me. If we do nothing, you may not even be able to find a doctor to sew up your wound. He’ll want an attorney behind him, and you’ll pay for both!

There’s only one solution to this. The HIPAA laws passed in 1996 must be reversed. And you can’t rely on your providers to do it for you. Your elected officials see physician efforts as self-serving. If you want to save your doctor, or other provider, from totalitarian medicine, YOU must take action. Contact your representatives immediately and ask them to look into this and reverse these laws.

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