Lower BAC for drunk driving on the way?

Mark Mandell, Esq

 

According to the release of the Michigan Annual Drunk Driving Audit, the number of drunk driving arrests in Michigan increased in 2012, as did the number of fatalities and injuries. 

 

Last year, the state made 37,182 alcohol- and drug-related driving arrests.  Deaths resulting from drug and alcohol induced crashes increased 7.2%, from 319 in 2011 to 342 in 2012.  Non-fatal injuries also increased.

While there was an increase last year, the overall trend in Michigan is positive – over the past 5 years, the number of traffic deaths involving alcohol has decreased 11.4%.

However, many believe Michigan’s drunk driving numbers are still too high and more needs to be done to deter this conduct.  For instance, the National Transportation Safety Board (NTSB) released its May 2013 Safety Report and advocates for decreasing the per se Blood Alcohol Content (BAC) limit from 0.08 to 0.05.

According to the report, studies have shown that a decrease in the BAC limit down to 0.05 reduces traffic fatalities by 8-12% for people ages 18-49.  In fact, more than 100 countries have established maximum per se BAC limits at or below 0.05 – including 25 of the 27 EU member countries.  Many traffic safety and public health organizations view BAC levels higher than 0.05 as posing an unacceptable risk for driving.

Opponents to the lower BAC limit point out that the majority of alcohol-impaired drivers in fatal crashes have BAC levels significantly higher than 0.08.  However, according to the NTSB, lowering the per se BAC limit changes the drunk-driving behavior of drivers at all BAC levels.  As a consequence, reducing the limit could reasonably be expected to have a broad deterrent effect on all drivers. 

Whether the per se BAC limit gets lowered is in the hands of the legislature; however, despite NTSB’s recommendation, there are no pending bills taking such action.  If you are facing drunk driving charges, or have questions regarding the law, contact experienced criminal defense attorney Mark Mandell at 888-674-1189 or online at www.MichiganFraudLawyer.com.

 

Amid Fraud Crisis, Medicare’s Accounting System Lacking Basic Information

Breeda O’Leary, Esq.
 

Despite the government’s aggressive approach in criminally prosecuting fraudulent providers, a report from the Department of Health and Human Services inspector general found that Medicare’s new accounting system failed to automatically extract critical data regarding providers.  This failure may lead to the inability to collect more than $543 million in overpayments to Medicare providers.

In 2010, Medicare overpaid providers more than $9.6 billion.  Since that time, Medicare has implemented a new accounting system – a system that failed to automatically extract provider and contractor information from the old accounting system.  As a result, Medicare does not have provider or contractor information critical to collecting from those that were previously overpaid.

In addition, the new Medicare accounting system allows information about providers to remain outdated, with little consequence for providers who fail to update their contact information.  Providers receive payments via direct deposit, thus eliminating the incentive to ensure that Medicare has a correct address in its accounting system.

According to agency spokesman Brian Cook, “Reducing the incidence of overpayments is a high priority for [Medicare].”  However, once a provider has been overpaid, having detailed information regarding the provider, such as a proper contact address, is critical to notifying the provider and collecting any overpayments.

While criminal prosecution of fraudulent providers continues to remain a priority for the government, the inspector general’s report highlights glaring deficiencies in Medicare’s new accounting system.  Medicare should address these deficiencies with the same sense of urgency as the criminal prosecution of fraudulent providers.

If you have been contacted concerning an overpayment or a possible criminal investigation, contact the experienced and professional fraud team at Fausone Bohn, LLP for sound legal advice.  Contact Breeda O’Leary at (248) 380-0000 or online at www.MichiganFraudLawyer.com. 

To read the article about the deficiencies in Medicare’s new accounting system, please visit:

http://www.usatoday.com/story/news/politics/2013/07/02/medicare-overpayments-unrecovered/2480429/

Medicare’s Disproportionate Fraud Rate

Mark Mandell, Esq.

 

It is difficult to truly understand the enormous fraud problem in the Medicare system.  To put it in perspective, look at the fraud rates of other industries:

             Credit card industry fraud - 0.04%.

            JPMorgan & Chase Co. fraud - 0.6%.

 Medicare?  It has a fraud rate of 8.5%.  Incredibly, Medicare and Medicaid fraud totals a whopping $60 billion annually.  That’s $60 billion taxpayer dollars not providing care to seniors but instead lining the pockets of criminals.

U.S. Representative Peter Roskam from Chicago has introduced a bill into Congress (HR 2305) that aims to update the Medicare system to combat fraudulent behavior and improper payments.

 

Some of the changes introduced in Rep. Roskam’s bill include updating the Medicare payment system.  Currently, the money goes out the door without any rigorous fraud checks.  The proposed change is modeled after the credit card industry – Medicare claims would go through two separate and distinct fraud checks at the beginning and the end of the process.  These checks occur before the money is paid out.

Additionally, the bill makes changes to reduce incidents of “dead” doctors prescribing drugs and increasing criminal penalties.  The bill also encourages increased education for seniors to identify and report fraud in the system.  Lastly, the bill increases communication between the Medicare and Medicaid systems to bolster security and fight improper payments.

With so many Americans paying into the Medicare system and the prospect of that system going bankrupt as early as 2026, we can’t afford to needlessly pay out $60 billion per year to criminals.  Changes, like those introduced by Rep. Roskam, need to be made to bring Medicare back on track.

If you have questions about Medicare or other types of fraud, contact the experienced team of fraud experts at Fausone Bohn, LLP at (248) 380-0000 or online at www.MichiganFraudLawyer.com.

To read about Rep. Roskam’s bill, visit: http://www.chicagobusiness.com/article/20130621/OPINION/130629969/how-to-cut-medicares-whopping-fraud-rate

 

One Year Delay in Enforcement of Employer Mandate

Tariq Hafeez, Esq.

The Obama Administration announced on July 2, 2013 that it would delay the implementation of a key provision of the Affordable Care Act--the employer mandate which will require employers with 50 or more workers to provide affordable health coverage to employees or risk tax penalties of up to $2,000 for each full-time employee that did not get health coverage.  The employer mandate was originally to take effect on January 1, 2014 but now will not be implemented until January 1, 2015.

The employer mandate has been a big source of anxiety and criticism in the business community as many business owners feel that the provision would be too costly to implement. Additionally, confusion remains on which businesses would be subject to the mandate as definitions of “full time” employees and what constitutes “affordable” insurance are complicated and subject to interpretation.

The delay in implementation of the employer mandate does not affect the other implementation timelines of the Affordable Care Act, including the opening of the health care exchanges in October 2013 and new tax credits to help individuals buy health insurance.

If you have questions about health care fraud or other legal issues, please contact Mark Mandell or Tariq Hafeez at 248.380.0000 or online at www.MichiganFraudLawyer.com.

Pharmacist Pays Big for Healthcare Fraud

Mark J. Mandell, Esq.

A medical professional convicted of health care fraud stands to lose nearly everything.

On June 10, Northville pharmacist Lokesh Tayal was convicted of one count of health care fraud conspiracy and one count of conspiracy to distribute controlled substances – both of which are felonies.  Mr. Tayal was sentenced to 5 years and 8 months of imprisonment and ordered to pay restitution of more than $3.6 million.

In addition, the Michigan Department of Licensing and Regulatory Affairs (LARA) has suspended Mr. Tayal’s pharmacy license. 

The conviction and license suspension stem from a case involving multiple area pharmacists.  According to the U.S. Attorneys on the case, the pharmacists participated in an elaborate scheme to defraud Medicare, Medicaid, and Blue Cross Blue Shield.  The pharmacists paid cash kickbacks and other illegal remuneration to physicians to get them to write prescriptions that were medically unnecessary.

The pharmacists then billed for expensive medication that was never disbursed or was not medically necessary, according to the U.S. Attorney’s office.

The U.S. Attorney summarized the Federal government’s current stance on health care fraud when she said “these defendants stole money from the Medicare and Medicaid programs, which are designed to provide health care and medicine to some of our most vulnerable citizens.” 

With the recent crackdown on fraud, medical professionals are facing not only hefty prison time and fines, but also the loss of their livelihood – revocation of their professional licenses.  If you have been indicted or are concerned about health care fraud, contact the experienced and professional fraud team at Fausone Bohn, LLP for sound legal advice.  Contact us at (248) 380-0000 or online at www.MichiganFraudLawyer.com. 

To read the article about these fraud convictions, please visit: http://www.hometownlife.com/apps/pbcs.dll/article?AID=2013306280006