Robert Andrew Smoley (aka B Andrew Smoley) spoke about the on-going problems with Medicaid fraud in the healthcare system. During a by-invitation only healthcare event, Robert Andrew Smoley focused an important part of his presentation on the huge, uncontrollable costs that Medicaid fraud continues to represent in the U.S. healthcare system.
Miami, FL -- (SBWIRE) -- 08/06/2015 -- Robert Andrew Smoley (aka B Andrew Smoley), a recognized leader in the healthcare technology space, discussed the high level of fraudulent activity in Medicaid services. While there has been a significant number of reports detailing the crack down on Medicare fraud, there have been very limited discussions on the rise of Medicaid fraud, which is only expected to grow with the expansion of Medicaid as result of Obamacare. State governments already lose billions of dollars annually on medical services that are fraudulently billed to their State-run Medicaid programs.
Discussing with reporters, a representative of Robert Andrew Smoley said, "Medicaid fraud must be brought under control before the public totally loses confidence in their governments' ability to manage the system. As more states expand Medicaid services, the opportunity for both patients and doctors to commit fraud also grows. Fraud within Medicaid costs taxpayers billions of dollars each year. Even more, it costs the government the faith of the people who expect it to detect and stop fraud in its tracks. " He further added, "Doctors are billing for services that were never rendered, or not to the right person, trumping up costs and altering records to get more money from the system. Similarly, Medicaid patients also commit fraud by doctor shopping, letting relatives and friends use their Medicaid cards, and gain access to services and medicines to which they are not entitled to. "
Smoley emphasized that the adoption of new technologies is critical and must be a priority when considering ways to reduce the level of fraud. In fact, Smoley has been an innovator in this area through his role as a Strategic Advisor to MedicFP, a company that provides fraud prevention solutions to prevent healthcare insurance fraud before services are rendered. One of the critical areas of preventing Medicaid fraud is identity validation and presence confirmation (two of the key services of MedicFP). Most Americans do not realize that the identity of patients are never validated in any systematic fashion. As long as you have a Medicaid, Medicare or other private pay insurance card in your possession, you can potentially gain access to medical services given the current absence of identity verification. In fact today, healthcare fraud is currently only identified after services have been rendered, usually referred to as the "Pay-and-Chase" strategy. Unfortunately, according to estimates by the U.S. government, less than half of the mere 10% identified via the "Pay-and-Case" methods of fraudulent activity is caught, and that process involves a significant amount of legal and administrative costs. If fraud is detected and prevented at the time of service, this would not only save tremendous investigative resources, but also substantially reduce the levels of Medicaid, Medicare and private pay insurance fraud.
Robert Andrew Smoley has extensive experience in the healthcare industry, particularly with healthcare technology. While he is recognized for his leadership in telemedicine as the founder of MDLive (a cloud based service helping users to interact with health care professionals and board licensed therapists via a smart app on their computer or phone), he is now playing a pivotal role in the healthcare fraud prevention space as a Strategic Advisor to MedicFP. B Andrew Smoley served as Chief Executive Officer of MDLive from 2006 to 2011. Robert has also assisted many companies that combine conventional services with disruptive, cutting edge technologies.
About Robert Andrew Smoley (aka B Andrew Smoley)
Robert Andrew Smoley began his career as an attorney and later started a number of successful companies over the past thirty years. Smoley also worked as a trial lawyer and was admitted to the Florida Bar in 1978. In 1985, he was personally sworn in by Chief Justice Earl Warren to become a member of the United States to present cases before the Supreme Court Bar. Robert was also elected the Mayor of North Bay Village, Florida, and became one of the youngest elected mayors in the United States and he served from 1976 to 1982. From 2006 to 2011, he served as CEO of MDLive (an online company that provides access to board-licensed therapists and doctors using cloud technology).
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