Cheating the system
14 April, 2011
Cheating the system

Mancho, a Georgian friend living in California works part time at a Russian doctor’s office. The office is small, but has a good multicultural staff of doctors and nurses, a good reputation, and as recently Mancho found out, ethics.
A new patient came in for her appointment. The health insurance the patient had is unavailable to an individual, which means only an employer can give it out to their employee. So the obvious fact is that anyone who carries this

insurance card has to have a job. Which is why Mancho was caught off guard when the patient speaking in perfect Russian offered that instead of paying a $20.00 co-pay, Mancho could just bill her insurance company twice. The patient suggested this transaction very matter of fact and for a good measure added that she had other doctors do the same thing all the time.
Mancho wasn’t too surprised. She had to deal with many patients of Russian origin who not only refuse to pay for doctor’s visits but demonstrate their intent in a very colorful language. Mancho knew that patents have been known to cheat the Health insurance system. There was a patient once who brought her children in and claimed on her chart that her husband divorced her and that’s why she had children under her last name. The patient’s insurance thought she was a single mom living in South LA, while in reality, she lived in one of the nicer LA neighborhoods in a house she owned with her  husband. There was another patient who lived in Beverly Hills and was on Medical, claiming to have no money. Mancho knew enough to know that without money, one can’t even park in Beverly Hills.
What Mancho wasn’t used was the blase attitude this patient had about admitting that she cheated the system. This, Mancho thought, I can do something about, so she asked the doctor what should she do? The doctor looked at her astonished and told her to never ever do anything illegal, or she would be fired. Mancho relayed the message to the patient with glee - pay up, or go home. The patient shrugged and opened her purse. Mancho’s triumph was short lived, as she happened to glance down as well. She had never seen so much money in a purse before.  All the bills were brand new and crispy, as if they just got off the printing press, and the patient was having a hard time finding a twenty amongst all the hundred dollar bills.
In Mancho’s experience, it was always newly printed bills. Always the brand new Lexus, D&G clothing, Gucci bags and Prada sunglasses. (In LA, the underrated accessory is sunglasses. If Sex and the City had been filmed in LA, Carried Bradshaw would have had a closet full of sunglasses instead of shoes.) Mancho has seen the latest collections prance through her doctor’s office. Yet the people wearing the latest designs did not want to pay the measly $20.00 co-pays. Mancho couldn’t understand why anyone would cheat for such a small amount of money. If you are going to cheat, at least go big, her thinking was. But as the Armenian Mafia bust in October, 2010 proved, not all cheating goes undetected.
Armenian Mafia consisted of a group of immigrants from former USSR. Headed by Armen Kazarian, a godfather like figure living fraudulently in the US, the group created 118 phantom health care clinics stealing doctors’ and patient’ identities to try to cheat Medicare out of $163 million, the largest fraud by one criminal enterprise in the program’s history. Most of the defendants “were Armenian nationals or immigrants and many maintained substantial ties to Armenia” and criminals there, the Federal indictment said. Couriers would often carry cash proceeds from the fraud back to Armenia, it added. The fraud was so franchised that it was business. As in every ill gained business, someone always gets too cocky and makes a mistake. Mancho personally thought anyone who didn’t do their homework and assigned a male patient to receive an ultrasounds and a female patient to get a colonoscopy should really rot in jail for their laziness. She also understood the appeal petty thieving had for some people. No FBI agent was going to waste his or her time checking up on small time thieves.
After an occasional “new money” visit, this time from a patient of Armenian origin, Mancho took a coffee break and ended up airing her grievances to a clerk in an office next door. While Mancho complained about the system being abused, the clerk had a different viewpoint.
Mancho just didn’t understand how to work the system, said the clerk showing off her brand new Michele watch (cost $1200.00) and that’s why she was never going to make any money. Mancho bit back, “That’s why you are always going to be just a crook.” The sad thing was, the clerk didn’t even hear Mancho, she was too busy admiring her watch.

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