HIV

What Healthcare Professionals are Saying about Bloodless Surgery

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While some of the basic ideas and concepts constituting what is known today as bloodless medicine have been around for centuries, the idea of a set of medical and surgical techniques aimed specifically at eliminating the necessity of blood transfusions has only been around since the 1960s. The idea was spurred mainly by Jehovah’s Witnesses, who became outspoken about their opposition to blood transfusions in the beginning of the 20th century.

Physicians were initially skeptical about performing complex surgeries and operations without using blood transfusions. However, after decades of campaigning and even federal court cases, Witnesses won the right to be treated without blood transfusions.

The early practitioners of bloodless medicine worked almost exclusively with Jehovah’s Witnesses to perform bloodless surgery. In many cases, doctors, nurses and healthcare professionals noticed the results from bloodless operations were actually better than similar operations where a transfusion had been performed. Benefits included quicker recovery times and lower costs. Eventually, these physicians began publishing their results, noting the advantages to these bloodless procedures over traditional blood transfusions. They also explained these benefits to other physicians and encouraged them to adopt the practices with non-Witness patients.

After surgeons in New Orleans and Los Angeles gained attention for performing bloodless open heart surgeries (or “bloodless hearts”), the popularity of bloodless surgery techniques with physicians began to spread around the world. By the late 1970s, bloodless medicine was available at healthcare systems in the U.S., Canada, Europe and India.

Not long thereafter, the public began to take notice as well. Concerns about the human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) led to people beginning to question where the source of donated blood used in transfusions was coming from. Fear over contracting AIDS through contaminated donor blood led to large numbers of non-Witness patients requesting bloodless surgeries.

Physicians have generally welcomed the increased demand for bloodless surgery in the modern medical climate. Bloodless surgeries have a number of specific advantages to both the patient and surgeon, as well as benefits to the hospital systems offering bloodless surgery. Because more than 50% of surgeries in the U.S. are pre-planned or elective surgeries, many doctors are actually encouraging their patients to consider blood transfusion alternatives.

Why do doctors and healthcare professionals like bloodless surgery methods? There are a number of specific reasons why a particular doctor or healthcare system might choose to offer bloodless medicine program. However, there are two huge advantages that benefit the doctor, the patient and the healthcare system.

1.) Bloodless Surgeries have fewer complications –

Fewer complications mean fewer post-surgery procedures and a quicker recovery time. This is obviously good for patients, but it is good for physicians as well. It frees up more of their time and lessens the likelihood that they could lose a patient in surgery.

Medicare Fraud and Abuse The Most Profitable Healthcare Crime in the U.S.

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Medicare fraud and abuse cost taxpayers approximately $60 billion a year. Its one of the fastest and most profitable crimes in the U.S. The government health insurance program that covers 46 million elderly and disabled Americans is being hijacked by opportunists preying on patients, doctors, suppliers, and lack of oversight of the system itself.

According to President Obama, Medicare fraud and abuse is fueling enormous federal budget deficits. He recently explained that we could pay for healthcare reform if we could eliminate Medicare fraud, abuse, and waste altogether.

Although completely eliminating Medicare fraud isnt entirely realistic, curbing the growing crimes could provide healthcare to many more Americans and stop lining the pockets of the individuals, crime rings, and corrupt healthcare providers that steal a huge amount of the half trillion dollars in Medicare benefits each year.

The instances of Medicare fraud and abuse are as diverse as they are widespread. One recent high-profile case involved an Armenian-American crime syndicate that stole patient and doctor identities to setup dozens of fake clinics. The operation, which is one of the largest Medicare fraud schemes in U.S. history, resulted in over $35 million in illegal billings.

In another Medicare fraud and abuse case, nine hospitals in seven states were ordered to pay $9.4 million in fines for keeping patients overnight after undergoing what is typically an outpatient back procedure. The hospitals fraudulently billed Medicare for the unnecessary services. In still another case, eight nurses in Florida carried out an $18.7 million Medicare fraud scam in which they forged patient files to make it appear that they required home health care services that they didnt need or receive.

Although these are just a few of the many types of Medicare fraud and abuse scams occurring each year, they show the urgent need to be vigilant about preventing Medicare scams. From charging for durable medical equipment (DME) never received to using a deceased doctors information to continue to bill patients, common Medicare fraud and abuse schemes include:

* Advertising “free” consultations to patients with Medicare, and then recording and using their private information for monetary gain

* Offering healthcare services or DME for free in return for a persons Medicare number for “record keeping”

* Setting up fictitious clinics with people impersonating doctors to steal private information and commit medical identity theft is another common Medicare fraud and abuse tactic

* Using real patients data, but without their knowledge, to steal their identities

* Not adhering to the FTC Red Flag Rules that alert the carriers paying the bills

* Fraudulent billing for a wheelchair, specialized hospital bed, or other DME is also a form of Medicare fraud and abuse

* Falsifying claims for expensive procedures is another common tactic, such as the $5.8 million fraudulent HIV infusion scheme in Miami in which a husband and wife team defrauded Medicare by submitting unnecessary HIV injection and infusion claims

Remember that when fraud happens to Medicare, it happens to all of us. Dont let your organization become a victim. Put your employees on the front line to spot Medicare fraud by hiring a healthcare fraud and abuse expert that provides “Lunch and Learn” presentations to help avoid, recognize, and respond to Medicare fraud. Visit www.TheIdentityAdvocate.com. or call 310.831.4400 to learn how to prevent Medicare fraud and medical identity theft.