Tag: Fraud

Every other month I attend a luncheon in Boca Raton at the Bova Cucina. It is a diabetes advocate and support group type meeting.  It is usually comprised of several CDE’s, diabetics, sales reps and a few MD’s.  The support group is put on by Murray Pincus.  Majority of you probably have no clue who Murray is, but if you are diabetic and live in the south Florida area, then you should know his name.  Murray is a great friend of mine and a terrific advocate of diabetes.

Today’s luncheon was comprised of 3 main parts.  Session one was a lecture on diabetes and kidneys by Dr. Frank Lavernia, who is an esteemed endocrinologist in south Florida.  He gave a great lecture on kidney disease being such a silent killer because so many people are living with it right now and have no idea.  Not just diabetics, but people in general.  Diabetics usually find out before non-diabetics because they should be getting tested for it.  Dr. Lavernia’s suggestion for finding out if you are at risk is simple, “Pee in a cup!”  He also explained that it is not just the high blood sugar that will affect your kidney’s, it is multiple things.  Cholesterol problems, high blood pressure, and there are multiple different factors that affect these problems as well.  And of course all of these risks increase with type 1 diabetes.  So to sum it all up, we need to make sure we go to the doctor’s follow the guidelines and be prepared by being ahead of the game and having tests done.

The next part was a talk given on Medicare fraud.  In south Florida, where I live, Medicare fraud is extremely high.  Mainly due to the obvious reasons, people retire to Florida.  There are also the snowbirds (people who come down south for the winter).  Snowbirds may be receiving supplies up north and may switch to a different company when they come down south and the DME can continue to bill for supplies that aren’t even being sent out.  And how can they dothis?  Because they rely on the elderly not paying attention to their statements and being “just old and out of it.”  There are organizations around the country now that do nothing but look at Medicare claims and make sure their are no fraudelent ones.  Unfortunately, there are not enough people doing it.  (Imagine what a national run healthcare reform would look like!)

Finally, it was summed up with a representative from CMS (Medicare).  He was there to talk about the H1N1 vaccine and if it’s covered by Medicare, who should get it, is it safe, etc.  Let’s start with his analogies.  CMS believes that everybody should get not just their seasonal flu shot, but also the H1N1 vaccine.  You can get these at the same time, 2 different shots, but at the same time.  For right now, the H1N1 vaccine requires a second booster shot, however that is beginning to change due to more recent research.  He explained the H1N1 vaccine as a seat belt.  Everybody should wear one.  If you don’t get into an accident, great, at least you were prepared.  However, if you do get into an accident then the person who is wearing a seat belt (the one with the H1N1 vaccine) is more likely to survive.  This was a good analogy.  Someone asked the question, is it safe to take, it hasn’t been around long enough to know the safety of it.  An MD responded, using the same analogy, “Don’t take the mindset that, ‘John Doe died because he was wearing a seat belt, if he wasn’t wearing it he would still be alive.”  As in, you know of one person that got sick from the H1N1 vaccine does not mean that every single person is going to get sick.

Now after all this, I must admit, I have never gotten a flu shot before.  I always think, what’s the point, I’m young, I don’t need a flu shot.  To me, the flu just means I’ll throw up a couple of times one day, have a bad fever, get the sweats, get the chills and then be over it in 2 days, no big deal to me.  As I get older, I understand that’s not going to always be the case.

What are your feelings / thoughts on it?