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Comment by johndhi | Hacker News Reader

My personal opinion is that the extremely high levels of activity in healthcare fraud prosecutions really aren't good for our country. They sound perfectly bipartisan and like no brainers (I haven't read into the details of this one but assume there are plenty of compelling details) - but it's just another 50lbs on the pile of "healthcare is highly complex and hard to do business in." These rules are BRUTALLY hard to comprehend for businesses.

The anti kickback statute and false claims act and cures act are all riddled with ambiguity and cases where normal intuitive business practices become criminal. It just stinks to do business with Medicare.

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Healthcare business are fine, the Healthcare industry in America is larger than the retail industry and accounts for 17% of the GDP. Americans spend more per capita on Healthcare than any country, and get worse outcomes. No one is scared about doing business in the industry because the profits are enormous.

The idea of just letting fraud go without prosecution in this industry is really hard for me to understand... Did you read the part where someone thought they were taking HIV medications, but because someone was profiting off fraud, they instead took anti-psychotic meds and were unconscious for 24 hours? We don't want to investigate that happening, because it might be bad for business? The business which is wildly thriving?

These aren’t people failing to jump through hoops.

I see medicare fraud nearly every shift…

>I see medicare fraud nearly every shift…

I hope you report it. I work a medical adjacent job and we get yearly training on how to report medicare fraud, waste, and abuse.

It’s too hard to prove it’s A) deliberate B) unnecessary.

It’s little things all day.

Meh, most of these people are parasites. I agree the government going after things like patient assistance programs for helping Medicare or TRICARE patients due to the AKS is probably bad.

But the typical prosecution is much more straightforward. A DME retailer whose “clients” are really just identify theft victims. A doctor who signed off on a bunch of things without ever meeting the patients. And some of it is going to get people killed. Especially when they do the scam where they buy HIV medicine from people who get it free and they use lighter fluid (!) to remove labels from the bottle and store the medicine in storage lockers and car trunks before some corrupt pharmacy buys it. Then the thief is back on the plane to whatever ex communist country they came from. There needs to be a deterrent because it is immensely profitable.

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