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posted by chromas on Sunday July 21 2019, @10:01AM   Printer-friendly
from the ever-wonder-why-health-care-is-so-expensive dept.

Ever since her 14-year marriage imploded in financial chaos and a protective order, Amy Lankford had kept a wary eye on her ex, David Williams.

Williams, then 51, with the beefy body of a former wrestler gone slightly to seed, was always working the angles, looking for shortcuts to success and mostly stumbling. During their marriage, Lankford had been forced to work overtime as a physical therapist when his personal training business couldn't pay his share of the bills.

So, when Williams gave their three kids iPad Minis for Christmas in 2013, she was immediately suspicious. Where did he get that kind of money? Then one day on her son's iPad, she noticed numbers next to the green iMessage icon indicating that new text messages were waiting. She clicked.

What she saw next made her heart pound. Somehow the iPad had become linked to her ex-husband's personal Apple device and the messages were for him.

Most of the texts were from people setting up workouts through his personal training business, Get Fit With Dave, which he ran out of his home in Mansfield, Texas, a suburb of Fort Worth. But, oddly, they were also providing their birthdates and the group number of their health insurance plans. The people had health benefits administered by industry giants, including Aetna, Cigna and UnitedHealthcare. They were pleased to hear their health plans would now pay for their fitness workouts.

Lankford's mind raced as she scrolled through the messages. It appeared her ex-husband was getting insurance companies to pay for his personal training services. But how could that be possible? Insurance companies pay for care that's medically necessary, not sessions of dumbbell curls and lunges.

Insurance companies also only pay for care provided by licensed medical providers, like doctors or nurses. Williams called himself "Dr. Dave" because he had a Ph.D. in kinesiology. But he didn't have a medical license. He wasn't qualified to bill insurance companies. But, Lankford could see, he was doing it anyway.

As Lankford would learn, "Dr. Dave" had wrongfully obtained, with breathtaking ease, federal identification numbers that allowed him to fraudulently bill insurers as a physician for services to about 1,000 people. Then he battered the system with the bluntest of ploys: submit a deluge of out-of-network claims, confident that insurers would blindly approve a healthy percentage of them. Then, if the insurers did object, he gambled that they had scant appetite for a fight.

By the time the authorities stopped Williams, three years had passed since Lankford had discovered the text messages. In total, records show, he ran the scheme for more than four years, fraudulently billing several of the nation's top insurance companies — United, Aetna and Cigna — for $25 million and reaping about $4 million in cash.

Read the rest at ProPublica.


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  • (Score: 4, Insightful) by Azuma Hazuki on Sunday July 21 2019, @10:01PM (25 children)

    by Azuma Hazuki (5086) on Sunday July 21 2019, @10:01PM (#869738) Journal

    In this post, and all others of the same kidney, is the inherent, implicit assumption that money is on an equal footing with, if not a higher footing than, humanity itself.

    Step back and ask yourself what the purpose of money and economic activity is. To promote human flourishing, no? In that case, even if a system is optimized for producing local maxima in terms of generating money, it is not necessarily producing optimal human flourishing...and indeed, by definition it cannot do so, since nothing directly ties "maximal revenue/profit" to "maximal human flourishing."

    Many of your delusions about the world will drop away when you address this fundamental moral priority-inversion glitch in your systems.

    --
    I am "that girl" your mother warned you about...
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  • (Score: 1, Offtopic) by The Mighty Buzzard on Monday July 22 2019, @10:41AM (24 children)

    Blah, blah, and also blah. You're seeing what you want to see instead of what's there so you don't have to be wrong again. Money's not on a higher footing than humanity in capitalism any more than the engine in your car is on higher footing than the occupants. You're just talking out of your ass again.

    --
    My rights don't end where your fear begins.
    • (Score: 0) by Anonymous Coward on Monday July 22 2019, @02:27PM (1 child)

      by Anonymous Coward on Monday July 22 2019, @02:27PM (#869959)

      You're such an idiot, guess that explains 2016. Bunch of morons too angry to deal with reality.

    • (Score: 2) by Azuma Hazuki on Monday July 22 2019, @09:50PM (21 children)

      by Azuma Hazuki (5086) on Monday July 22 2019, @09:50PM (#870096) Journal

      The projection is incredible. Look, shitbird, just because *in theory* money isn't on a higher footing under capitalism doesn't mean that it isn't in practice. I'm talking about reality here, not some toy model your utopian gibbertarian friends like to masturbate to before they go to bed in their mothers' basements.

      --
      I am "that girl" your mother warned you about...
      • (Score: 1, Flamebait) by The Mighty Buzzard on Tuesday July 23 2019, @04:50AM (20 children)

        I know it hurts your butt to hear that the people you want to hate aren't the monsters you want to paint them as but reality isn't going to change just because it doesn't suit you.

        --
        My rights don't end where your fear begins.
        • (Score: 2) by Azuma Hazuki on Tuesday July 23 2019, @09:53PM (19 children)

          by Azuma Hazuki (5086) on Tuesday July 23 2019, @09:53PM (#870482) Journal

          Monster is as monster does. You, somehow, think you're going to gain some advantage or other by pretending to be one of them. Unfortunately, the most you can manage is to be a annoying little dingleberry on one specific forum you have some editorial clout over.

          This is because--spoiler alert!-- y o u a r e s m a l l t i m e.

          --
          I am "that girl" your mother warned you about...
          • (Score: 2) by The Mighty Buzzard on Thursday July 25 2019, @10:25AM (18 children)

            I have plenty of coding clout and a moderate amount of admin clout but I don't have any more editorial clout than you do. Or rather any more than you would if you didn't routinely take a flying leap off the deep end of sanity.

            --
            My rights don't end where your fear begins.
            • (Score: 2) by Azuma Hazuki on Thursday July 25 2019, @11:42AM (17 children)

              by Azuma Hazuki (5086) on Thursday July 25 2019, @11:42AM (#871002) Journal

              So you're even weaker than I expected then. And if you want to bitch about ad-homs, "flying leap off the deep end of sanity" is a perfect example. You project like the proverbial mile of movie theaters, and all here know it; you're pissing into the wind with that crap now. We've had plenty of time to show this forum what sort of people we are, and the verdict is long since in.

              --
              I am "that girl" your mother warned you about...
              • (Score: 1, Troll) by The Mighty Buzzard on Thursday July 25 2019, @01:35PM (16 children)

                We've had plenty of time to show this forum what sort of people we are, and the verdict is long since in.

                And yet you go on thinking you're the sane one. Interesting.

                --
                My rights don't end where your fear begins.
                • (Score: 2) by Azuma Hazuki on Friday July 26 2019, @06:57PM (15 children)

                  by Azuma Hazuki (5086) on Friday July 26 2019, @06:57PM (#871586) Journal

                  I've met people on large doses of quetiapine who are, in the aggregate, saner than you. And yes, that includes the ones who are convinced there's some kind of insane government plot going on.

                  --
                  I am "that girl" your mother warned you about...
                  • (Score: 1, Troll) by The Mighty Buzzard on Saturday July 27 2019, @02:13AM (14 children)

                    Just a heads up: You have something massively wrong with your sanity scale. That's to be expected with some of the bat-shit-crazy things you believe without question though.

                    --
                    My rights don't end where your fear begins.
                    • (Score: 2) by Azuma Hazuki on Saturday July 27 2019, @01:05PM (13 children)

                      by Azuma Hazuki (5086) on Saturday July 27 2019, @01:05PM (#871900) Journal

                      Tell me, have you ever had a dissociative episode? Because the only way you could say something that completely un-self-aware and still be counted mentally competent is if you do. The projection is incredible. Your entire "libertarian" worldview is based on a false understanding, willfully held in the face of overwhelming evidence, of what "freedom" actually means. That, and an amazingly bloated ego.

                      --
                      I am "that girl" your mother warned you about...
                      • (Score: 2) by The Mighty Buzzard on Saturday July 27 2019, @03:12PM (12 children)

                        Nope. Afraid I'm about as grounded in reality as it gets. Part of that means I don't go jumping through mental hoops to call comfort liberty. Liberty just means the government stays the fuck out of my choices and punishes people who seek to harm others in the most egregious manners. Not who make life more difficult others incidentally but without malice. And not those like you who actively seek to harm others, with malice, in lesser atrocious ways.

                        --
                        My rights don't end where your fear begins.
                        • (Score: 2) by Azuma Hazuki on Saturday July 27 2019, @09:16PM (11 children)

                          by Azuma Hazuki (5086) on Saturday July 27 2019, @09:16PM (#872092) Journal

                          Once again, you make my point for me...and you're so completely Klein-bottled up your own ass you don't even see how or why. Try this: "as simple as possible, but no simpler." Sometimes as simple as possible is quite complex indeed.

                          --
                          I am "that girl" your mother warned you about...
                          • (Score: 2) by The Mighty Buzzard on Saturday July 27 2019, @10:48PM (10 children)

                            Only if you set out with the answer you want your reasoning to give you firmly in mind and distort everything along the way until you get there. If you're allergic to rhetorical bullshit and the changing of definitions to suit your needs, you end up where I am. Liberty and comfort are not the same. Liberty and security are not the same. Hell, even liberty and life are not the same. Pick whatever ideal you like and stand behind it but don't go trying to bullshit me about the one I've picked, because I know it a lot better than you do.

                            --
                            My rights don't end where your fear begins.
                            • (Score: 2) by Azuma Hazuki on Sunday July 28 2019, @09:07PM (9 children)

                              by Azuma Hazuki (5086) on Sunday July 28 2019, @09:07PM (#872401) Journal

                              You're missing the point: you have this weird, idealistic, oversimplified version of "liberty" that at bottom translates to "as few restrictions as possible." It shouldn't take more than a few seconds of logical thought to see the flaw in that definition. Yet somehow, you won't, or can't, do the necessary brainwork. This tells me you're either a lot stupider than even I thought, or you truly don't give a shit about anything except thinking you're correct and reality can go take a flying leap. Neither one speaks well of you.

                              It's very clear that what you actually mean is "liberty for me personally and to Hell with everyone else," and you just try and dress it up with libertarian talking points, points you only half-comprehend at that.

                              --
                              I am "that girl" your mother warned you about...
                              • (Score: 2) by The Mighty Buzzard on Sunday July 28 2019, @11:23PM (8 children)

                                Nah, you just can't get that liberty does not mean anything but liberty. It has nothing to do with what choices you have available to you, only that you are free to make the ones you have. What you want is not liberty. What you want is a utopia that you've dreamed up in your own head and anyone violating what you think is best gets hell rained down on them. You're a genocidal despot in all but the power to do anything about your desires.

                                --
                                My rights don't end where your fear begins.
                                • (Score: 2) by Azuma Hazuki on Monday July 29 2019, @10:22PM (7 children)

                                  by Azuma Hazuki (5086) on Monday July 29 2019, @10:22PM (#872864) Journal

                                  Unbelievable. You're saying that someone in 1880s America whose only choices were "work in a sweatshop or die" was *freer* than someone in modern Norway. Un-fucking-believable.

                                  Your vision can be trivially reduced to absurdity in a near-infinite number of ways like the above. In fact, according to you, even when someone has only two choices, with death being one of them, they "have their liberty." That's insane. Certainly it doesn't comport with any understanding of the word "freedom."

                                  --
                                  I am "that girl" your mother warned you about...
                                  • (Score: 2) by The Mighty Buzzard on Tuesday July 30 2019, @12:28AM (6 children)

                                    No, I'm saying that those were never their only choices. Only morons who think things have to be given to them for them to have them (a means of acquiring wealth in this case) are so blind that they think nonsense like that.

                                    --
                                    My rights don't end where your fear begins.
                                    • (Score: 2) by Azuma Hazuki on Thursday August 01 2019, @10:17PM (5 children)

                                      by Azuma Hazuki (5086) on Thursday August 01 2019, @10:17PM (#874303) Journal

                                      I guess you're never going to get this until it happens to you, are you? Oh well. Odds are good you're coming back somewhere in China or India or the Sahel next time, after you've done your time in Hell. You'll figure it out eventually...

                                      --
                                      I am "that girl" your mother warned you about...
                                      • (Score: 1, Troll) by The Mighty Buzzard on Friday August 02 2019, @11:40AM (4 children)

                                        Dumbass, it has happened to me. It's happened to everyone who ever faced a choice between putting in the work to acquire skills that can be bartered for a comfortable living, taking a risk on their own venture, or taking a shitty job. Don't cry to me because you're too lazy to put the effort in or too cowardly to risk financial ruin.

                                        --
                                        My rights don't end where your fear begins.
                                        • (Score: 2) by Azuma Hazuki on Saturday August 03 2019, @01:47PM (3 children)

                                          by Azuma Hazuki (5086) on Saturday August 03 2019, @01:47PM (#875122) Journal

                                          You don't know either my current situation or my upbringing, so I will forgive you for the ignorance displayed in that post. I'll just say you're wrong, so far wrong you're not even on the map any longer. You owe me an apology, or would if you had the facts. As it is, I'll just chalk it up to that all-consuming ego of yours...

                                          --
                                          I am "that girl" your mother warned you about...
                                          • (Score: 2) by The Mighty Buzzard on Saturday August 03 2019, @02:02PM (2 children)

                                            by The Mighty Buzzard (18) Subscriber Badge <themightybuzzard@proton.me> on Saturday August 03 2019, @02:02PM (#875128) Homepage Journal

                                            Yeah, your shit didn't turn out like you wanted it to so I must be wrong. Fucking please.

                                            Here, let me state this as directly as I can: You are not entitled to jack shit as far as financial comfort or success goes. You are not entitled to pick any career you like and make a good living at it. You are not entitled to government protection of your means of making a living.

                                            You, me, and everybody else has to make their own way in this world. Sometimes you get the bear, sometimes the bear gets you. Pissing and moaning for government help from a position at the bottom is no less bullshit than the banks asking for a bailout. Either one requires that your fist not stop swinging when it gets to my nose, or in this case wallet. I'm happy to help those in need but you can fuck right off with demanding help from me at gunpoint.

                                            --
                                            My rights don't end where your fear begins.
                                            • (Score: 2) by Azuma Hazuki on Saturday August 03 2019, @02:28PM (1 child)

                                              by Azuma Hazuki (5086) on Saturday August 03 2019, @02:28PM (#875140) Journal

                                              "Fuck you, got mine, and damn the consequences." You talk too much for someone with so little to say.

                                              --
                                              I am "that girl" your mother warned you about...
                                              • (Score: 2) by The Mighty Buzzard on Saturday August 03 2019, @02:36PM

                                                by The Mighty Buzzard (18) Subscriber Badge <themightybuzzard@proton.me> on Saturday August 03 2019, @02:36PM (#875146) Homepage Journal

                                                I'm happy to help those in need but you can fuck right off with demanding help from me at gunpoint.

                                                "Fuck you, got mine, and damn the consequences." You talk too much for someone with so little to say.

                                                See? Denial of reality. And you still won't see it.

                                                --
                                                My rights don't end where your fear begins.