Filed under: Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance | Tagged: Fraud and Abuse Costs and Cases Rose, Health Capital Consultants LLC, healthcare fraud, medical fraud |
As a former Dean and appointed University Professor and Endowed Department Chair, Dr. David Edward Marcinko MBA was a NYSE broker and investment banker for a decade who was respected for his unique perspectives, balanced contrarian thinking and measured judgment to influence key decision makers in strategic education, health economics, finance, investing and public policy management.
Dr. Marcinko is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; as well as Oglethorpe University and Emory University in Georgia, the Atlanta Hospital & Medical Center; Kellogg-Keller Graduate School of Business and Management in Chicago, and the Aachen City University Hospital, Koln-Germany. He became one of the most innovative global thought leaders in medical business entrepreneurship today by leveraging and adding value with strategies to grow revenues and EBITDA while reducing non-essential expenditures and improving dated operational in-efficiencies.
Professor David Marcinko was a board certified surgical fellow, hospital medical staff President, public and population health advocate, and Chief Executive & Education Officer with more than 425 published papers; 5,150 op-ed pieces and over 135+ domestic / international presentations to his credit; including the top ten [10] biggest drug, DME and pharmaceutical companies and financial services firms in the nation. He is also a best-selling Amazon author with 30 published academic text books in four languages [National Institute of Health, Library of Congress and Library of Medicine].
Dr. David E. Marcinko is past Editor-in-Chief of the prestigious “Journal of Health Care Finance”, and a former Certified Financial Planner® who was named “Health Economist of the Year” in 2010. He is a Federal and State court approved expert witness featured in hundreds of peer reviewed medical, business, economics trade journals and publications [AMA, ADA, APMA, AAOS, Physicians Practice, Investment Advisor, Physician’s Money Digest and MD News] etc.
Later, Dr. Marcinko was a vital and recruited BOD member of several innovative companies like Physicians Nexus, First Global Financial Advisors and the Physician Services Group Inc; as well as mentor and coach for Deloitte-Touche and other start-up firms in Silicon Valley, CA.
As a state licensed life, P&C and health insurance agent; and dual SEC registered investment advisor and representative, Marcinko was Founding Dean of the fiduciary and niche focused CERTIFIED MEDICAL PLANNER® chartered professional designation education program; as well as Chief Editor of the three print format HEALTH DICTIONARY SERIES® and online Wiki Project.
Dr. David E. Marcinko’s professional memberships included: ASHE, AHIMA, ACHE, ACME, ACPE, MGMA, FMMA, FPA and HIMSS. He was a MSFT Beta tester, Google Scholar, “H” Index favorite and one of LinkedIn’s “Top Cited Voices”.
Marcinko is “ex-officio” and R&D Scholar-on-Sabbatical for iMBA, Inc. who was recently appointed to the MedBlob® [military encrypted medical data warehouse and health information exchange] Advisory Board.
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DOJ Charges Hundreds with $6B in Healthcare Fraud
The Department of Justice (DOJ) charged 345 people across 51 federal districts in the largest healthcare fraud takedown in the agency’s history. The DOJ said the charges were in connection with cases responsible for more than $6 billion in losses. Among those charged were more than 100 doctors, nurses, and other medical professionals, according to the DOJ.
The billions in false claims were submitted to both public and private insurers, the DOJ said, with more than $4.5 billion connected to telemedicine schemes. Alongside the fraud takedown, the Centers for Medicare & Medicaid Services (CMS) said it would revoke Medicare billing privileges from 256 medical professionals in connection with telemedicine fraud.
Source:
Fierce Healthcare [9/30/20]
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Methodist Healthcare Accused of Paying Kickbacks to Oncologists
Methodist Le Bonheur Healthcare (MLH), a non-profit healthcare system consisting of five hospitals as well as outpatient and ancillary services, has been accused of paying kickbacks in exchange for patient referrals. Between 2012 and 2018, over $400 million was allegedly paid by MLH for referrals from physicians at The West Clinic, a Memphis, Tennessee based, for-profit private physician group of medical oncologists, gynecologic oncologists, radiologists, and other physician specialists.
The relators, a former MLH executive leadership team member and the former CEO for Methodist University Hospital, claim that MLH induced the referrals of cancer patients to their facility through kickback payments made to The West Clinic, in violation of numerous fraud and abuse laws.
https://www.healthcapital.com/hcc/newsletter/10_20/HTML/METHODIST/convert_hc_topics_methodist_10.26.20.php
Dr. David E. Marcinko MBA
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US Healthcare Spending Waste is $1,800-$5,700 Per Person Per Year
The American Journal of Public Health recently published an analysis of healthcare spending waste in the US by Arizona State University researchers. Here are some key findings:
• Between $600 billion to more than $1.9 trillion of US healthcare spending is wasted every year.
• Healthcare spending waste in the U.S. is between $1,800 and $5,700 per person, per year.
• Reducing spending by 7% between now and 2030 would get the US to the levels of other countries.
• Reducing spending by 3.3% annually until 2040 would get the US to the levels of other countries.
Source: Arizona State University, November 17, 2020
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