A Monroe doctor has agreed to pay nearly $1 million dollars to the N.C. Medicaid program for defrauding Medicaid. According to authorities, Dr. Millicent Francis-Lane submitted requests to Medicaid for reimbursements for procedures she actually didn't perform between 2003 and 2009. Dr. Francis-Lane's settlement is a result of the U.S. Attorney for Charlotte and the Western District of North Carolina's pursuit to uphold the False Claims Act, a program intended to protect Medicaid and other programs from fraud.
Defrauding Medicaid and other health care programs presents a growing obstacle to the public's access to health care. These health care programs are taxpayer funded, meaning their resources are not infinite. Furthermore, a large amount of people rely on the services provided by these health care programs. As fraud increases, their resources deplete, meaning the programs cannot meet the need for their services. In other words, the availability of these health care programs decrease, the services they provide decrease, and the public's access to health care and quality services further decrease.
This problem is further exacerbated in North Carolina as businesses are shifting health care costs on to their employees. According to the National Survey of Employer-Sponsored Health Plans, sixty percent of the N.C. employers surveyed plan to shift insurance costs on to their employees by raising deductibles, co-pays and out of pocket expenses. This is a trend that has nationally increased over the past year, and according to the survey, half of the employers surveyed plan to continue this trend next year. Employers are also shifting the costs by including employee incentives in their insurance plans for certain employee behaviors; however, these plans also usually include penalties for other behaviors such as smoking and obesity.
As uncertainties in health care reform continue to resonate, insurance costs for employees will rise. Similar to the effects of defrauding Medicaid, increasing insurance costs will decrease the public's access to health care. In an unstable economy where the public is already struggling to afford health care costs, lumping more costs on the average citizen will be even more economically taxing on the public. This will lead to an increase in the need for public health care programs such as Medicaid. However, as discussed above, these resources are not infinite and deplete quickly as more people are in need of them and as doctors defraud the services. Ultimately, they both lead to the same problems: an increase in the public's need for assistance in affording health care and the lack of their access to health care because of the lack of assistance available for the large amount of people who need it. Nationally, this could lead to more problems in the nations' deficit and the lack of funding for health care programs, thereby creating a vicious cycle of the problems discussed above.
As always, it is always important to consider these problems before choosing a medical plan for you and your loved ones. These medical concerns and health reform are an even more important issue to consider during elections. I urge you to not only consider them choosing your elected representative, but to contact your representative with any concerns you may have.
CharlotteObserver.com, "Monroe doctor to pay nearly $1 million for Medicaid fraud," 11/17/11
CharlotteObserver.com, "N.C. employers plan to pass health care costs on to workers," 11/17/11
