Monday, January 10, 2022

Not on My Watch by Howard Gershkowitz #MuseMonday


How about a little information while you're being entertained? Please welcome my guest, Howard Gershkowitz, who has just that for you on this Muse Monday. 

Recent headlines in the news have pointed out a pattern of Medicare fraud at hospitals, clinics and other medical facilities across the country. From fake billing to unnecessary procedures, it seems we have an epidemic of greed at the very institutions we rely on for our care, especially for our senior citizens. A change in how the government processes payments to Medicare providers is at the heart of the problem. In an effort to reduce the amount of time that legitimate claims are paid, a policy of ‘pay first, question later’ has encouraged fraudsters to submit massive amounts of false claims with the expectation they will be paid quickly and, in many cases, move on before any investigation can catch up to them. One possible solution would be to slow payment processing down to allow for investigators to uncover fraud before the check is sent. Another would be to enhance the enforcement arm of the government to catch these tricksters before they can skip town. In the meantime, if you need care, you can do your part to make sure your bill is accurate and doesn’t contain questionable charges. If you receive a notice that a payment was made on your behalf from your insurance provider, look it over before filing or tossing it ensure it is legitimate and not a ‘ghost’ bill for appointments or procedures you never went to.

She walked in wearing high heels and attitude. Steven looked up from his Wall Street Journal and their eyes meet. Former classmates, they re-connect, but is it truly by chance? Or something more calculated? Before long, she embroils him in her fight to defend her hospital—and her nursing career—from the clutches of a ruthless Boston medical syndicate run by her ex-husband. Their only chance to stop the takeover is to run a dangerous sting operation that could cost them their careers – or worse. 

Excerpt – prologue and chapter 1

Dateline; Boston, MA, September 8, 2021

In other noteworthy news, C & C and Associates, the local Medical powerhouse, has announced plans for another acquisition, this time in Texas. The merger, announced jointly today in the Boston Herald and Dallas Times, will be the eleventh major hospital chain to join the ever-growing empire of CEO and former corporate raider, Delbert Carter.

Dr. Harry Steinham, head of personnel for the conglomerate, spoke to reporters at a press conference at their downtown headquarters. “We are pleased to welcome Dallas General to our growing family of community-based facilities. Known for their long-standing commitment to superior treatment standards and charitable outreach programs, they represent the type of facility that C&C is excited to partner with.”

Asked about growing concerns in the industry about consolidations and declining levels of service to the poor and under-insured, Steinham commented, “We are committed to helping those who can’t help themselves.” When pressed about disturbing reports in communities already served by C&C’s affiliates, Steinham waved a stack of satisfaction surveys, claiming they contradicted the claims. “Anyone can download these from our corporate website and see for themselves. We provide only the finest care to our patients.”

Steinham indicated more acquisitions were already in the works, the next one likely to be in the Southwest again. C & C stock closed at a new yearly high today in heavy trading on the New York Stock Exchange. 

Chapter 1

Trouble walked in wearing high heels and attitude.Shoulder-length brown hair framed her smooth, high cheek bones. Stopping well shy of the register, she scanned the tables as if looking for someone to buy her a drink. When her eyes caught mine, they lingered a second too long. A half-smile creased her lips, disappearing so quickly I was unsure I saw it at all. Strolling casually to the periodicals rack, she picked up a Vogue and began browsing.

I sipped my coffee and tried refocusing on the Journal article in front of me, but there’d been something unsettling in her glance. Was I supposed to respond? Offer to wait in line so she wouldn’t have to? If this were a bar, with its clear, unspoken rules, the choice would be easy. I was unaware of such protocols at Starbucks however, especially ones located inside a bookstore on a rainy, September afternoon.

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  1. Thank you for sharing - I hope you enjoy this little excerpt. Glad to answer any questions you may have


    1. Great to have you as a guest today, Howard.

    2. Thanks again for having me. Hope 2022 started out well for you and your fans!

  2. Howard, I loved hearing your explanation contributing to the fraud that seems to run prevalent throughout the government when it comes to payments. There should be some happy medium--the government doesn't take too long to make a payment and everyone helps to stop fraudulent claims. It's staggering the amount of money that gets paid out to the undeserving--like in the last two years' COVID relief payments--and maddening, too. Your book sounds wonderful!

    1. Than you - appreciate the feedback. I work in the financial services field and I am always amazed at how 'solutions' to problems (government or otherwise) always seem to cause more issues than they solve!

  3. Very informative Howard. Thanks for sharing!