Beyond The Celebrity's Mask

Image courtesy of www.scholastic.ca

Every organization is founded on a mission, a sense of purpose to accomplish goals and objectives as defined in the organization's vision statement. Thus it is a very serious endeavor that an organization must be headed by an individual of unquestionable integrity, a name that is well-respected in the community. The thrust of the organization's commitment depends a great deal if the above standards are met by the individual who will run it. .

Thus, it is quite a shock when you hear of a person who is supposed to have an untarnished image and a pillar of goodness, compassion and honesty being talked about as being involved in funds misuse and abuse of power.

This good looking and popular celebrity GP who heads a big non profit organization NGO tasked to help the poor and underprivileged is allegedly engaged in malversation of funds --- the organization's funds for that matter. Sounds unthinkable and conflicting for GP's public persona. But there have been persistent and strong insider information that point to GP's extra curricular activities and misuse of these funds.

GP is well known for having a fastidious lifestyle. It was alleged that GP draws funds from the NGO to pay for personal credit card bills amounting to Php 300,000 to 500,000 per month! The scandalous figure sounds like the NGO is the one tasked to shoulder the fabulous lifestyle. And why not, even the monthly payment for the personal dance instructor aka DI allegedly comes from the NGO funds itself.

Do the regular donors of the NGO know where their hard-earned money is being squandered? Aren't these funds supposed to be used to take care of the poor and the oppressed in the first place? So many questions that need to be addressed immediately. Well, we can only hope and pray for the best.

”Real integrity is doing the right thing, knowing that nobody's going to know whether you did it or not.” --Oprah Winfrey

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Here are the seven factors driving health care cost increases

Escalating health care costs are everybody's problem and no one entity's fault. Julie Appleby at Kaiser Health News reports that the United States spends about18 percent of its gross domestic product -- or about $2.6 trillion a year -- on health care costs. So what's making that figure rise? A Bipartisan Policy Center study took on the task of finding out and came up with it believes are seven major factors:

1. Paying our doctors, hospitals and other medical providers in ways that reward doing more, rather than being efficient. Even insurers like Medicare pay on a fee-for-service system. New efforts in the federal health law look to change that.
2. Growing older, sicker and fatter as a nation.Medicare is set to grow by an average of 1.6 million people annually. With two-thirds of adults are either overweight or obese, lots of additional medical spending looms.
3. Wanting the latest drugs, technologies, services and procedures. Prices for newer treatments are often higher than for the products they replace.
4. Employers and employees get tax breaks on health insurance, and it costs employees little to seek care. Appleby writes, "The majority of people with insurance get it through their jobs. The amount employers pay toward coverage is tax deductible for the firm and tax exempt to the worker, thus encouraging more expensive health plans with richer benefits, the report says. How that coverage is designed also plays a role: Low deductibles or small office co-payments can encourage overuse of care, the report says. Increasingly, however, employers are moving toward high-deductible coverage as a way to slow premium growth and require workers to pay more toward the cost of care."
5. Not having enough information to make decisions on which medical care is best for us.
6. Hospitals increasingly gain market share through consolidation and demand higher prices.
7. Legal issues complicate efforts to slow spending. Doctors sometimes prescribe tests or treatment out of fear of facing a lawsuit, the report says. Fraudulent billing is another concern. The report notes that laws sometimes limit the ability of medical professionals to do work for which they are trained but that more highly paid doctors must do. (Read more)

To read the entire Bipartisan Policy Center report here.

Chiropractic clinic to pay $650K for Medicaid and Medicare fraud

A chiropractic clinic in Williamsburg will pay $650,000 to settle claims it improperly billed Medicare and Medicaid, reports Trent Knuckles for The News Journal of Corbin. (News Journal graphic)

Ho Medical Clinic, Kenneth Ho and Ana Moreno allegedly filed false claims when they billed for physician services, though they were performed by a chiropractor (chiropractors are not medical doctors); billed for unnecessary and unreasonable MRI and X-ray services; billed for work performed by unqualified personnel; and received funds for being a rural health clinic when it did not meet Medicare requirements.

Of the $650,000, $525,000 will go to the Medicare and Medicaid trust fund. The remaining sum will go to Danette Freeman, who sued the company under the False Claims Act. The investigation was conducted by the Kentucky attorney general's office, the Department of Health and Human Services' Office of Inspector General and the U.S. attorney's office. (Read more)

Two bills would encourage, protect whistleblowers

Two proposed bills would serve to crack down on fraudulent health care claims and make it easier for employees to blow the whistle on illegal activity.

State Sen. Tom Jensen, R-London, (photo, right) has sponsored Senate Bill 11, which would increase damages and penalties against wrongdoers and prohibits retaliation against employees who assist in prosecution. It would also allow an employee who "works for a Medicaid provider or contractor to turn over evidence to prosecutors and receive a portion of the money recovered," The Lexington Herald-Leader's Beth Musgrave reports.

House Bill 4, sponsored by House Speaker Greg Stumbo, D-Prestonsburg, (photo, left) proposes similar action, likewise protecting whistleblowers and paying "some of the proceeds of the action being distributed to the person successfully bringing the action." The consequences as proposed in Stumbo's bill would be more widespread, however. "I want to see this used not just in (Medicaid), as the Senate is proposing, but anywhere fraud with state dollars is taking place," Stumbo said.

Almost two dozen states have their own false claims acts, including Tennessee and Indiana. Attorney General Jack Conway has expressed some concerns about the proposals. (Read more)