Beware Your Doctors When On Medicare

It’s been over six months and I have seen at least 5 different specialists (at one group location, Crystal Run) and not one of them has been able to cure my cough! I’m still hacking away. I have a sneaky suspicion I have something serious BUT the doctor treating me isn’t sure yet so she tells me nothing. She found a spot on my lung but wants to watch it every six months. My pulmonologist told me it may be two years before she can give me a correct diagnosis. In other words, I think this doctor is full of shit and I have wasted three months of my life with this idiot.

I always advise people to trust their gut. I had this feeling that the doctors were just passing me around, ordering all these tests, that always came back negative, just to bill Medicare. My husband pooh-poohed me, but it’s how I felt. How could five specialists NOT find anything wrong with someone who has a constant cough? Well, trust your gut people, because your gut is never wrong. Turns out this medical group is under investigation with the FBI due to illegal donations and kick-backs made to our state governor.

FBI agents are actively investigating Crystal Run Healthcare, a Hudson Valley company whose officials have made $400,000 in political donations to Gov. Andrew Cuomo, the Times Union has learned. The agents are being assisted by personnel from the Orange County district attorney’s office, and have sought information about the political donations to Cuomo as well as $25 million in grants awarded to the company by the state Department of Health.

After learning about this FBI investigation, I decided to go back to my original medical group, Health Quest, only to find out this:

Health Quest Systems, Inc. and certain of its subsidiaries (Health Quest) and Putnam Health Center (PHC) have agreed to pay over $14.7 million to resolve allegations of violations of the False Claims Act by submitting inflated and otherwise ineligible claims for payment, the Justice Department announced today. New-York based Health Quest is a family of integrated hospitals and healthcare providers that deliver surgical, medical and home health care services. PHC is a Health Quest subsidiary hospital based in Carmel Hamlet, New York. “This resolution is a testament to our deep commitment to protecting the integrity of federally- funded healthcare programs,” said Acting Assistant Attorney General Chad A. Readler for the Justice Department’s Civil Division. “We are determined to hold accountable healthcare providers that knowingly claim taxpayer funds to which they are not entitled.

Do you remember a few months ago I wrote this post stating that for some unknown reason we got a bunch of refund checks back from our health care provider, Health Quest? And I used that “found” money to remodel my bedroom? Turns out, our doctor’s administration was re-examined and found guilty of double billing his clients. Thus the refund (that the medical office threatened to put us on collection if we didn’t pay, despite our argument that our medical insurance was supposed to pay). Well, the medical insurance did pay. And so did we.

I called back my original pulmonologist who I saw in 2015 but the earliest appointment I can get with him is in late September. The receptionist told me if I have a health issue to go to the ER at my local hospital. But that’s the hospital that has been indicted for double billing and truthfully, at this point I don’t trust anyone or anything anymore. I’m in a real quandary and meanwhile I’m so tired of constantly coughing I’m thinking of jumping off the Hudson Bridge or something just to end this pain and this nightmare.

Besides being despondent, I’m disgusted. I’ve fallen into a deep depression. I started thinking about my daughter’s own mother-in-law who has also been having a rough time with her own health care lately. Apparently, at age 70, she has exhausted her lifetime cap on her own Medicare and had to move into an assisted living home in order to get the proper care she needs. She has been going through one medical mishap after another. First it was her heart and she had an operation on that. Then the doctors said she needed a knee replacement but that operation didn’t go over too well. She was in constant pain. On constant meds, unable to walk without assistance. Windup is that last month she stopped taking all her meds and wanted to commit suicide and die.

After what I have been going through, I now can understand how this woman came to this conclusion. Which makes me think: is there some kind of  conspiracy in Medicare that makes a recipient so despondent that they kill themselves thus saving Medicare a bundle of money over the long haul? Don’t be so smug or discard what I am saying. Look above. Both medical facilities I have been going to lately have been in a heap of financial trouble and woes. Is there really something going on here with Medicare?

In the interim, I did go to the Emergency Room yesterday because I just couldn’t stop myself from coughing. I met a very nice (and handsome doctor) who told me right from the start that he couldn’t help me. He was trained to stitch people up. Not investigate coughs. But we discussed my past medical care and my future medical care and he told me I was on the right path. One of my future appointments should come up with a good reason for my coughing and subscribe the correct meds. In the meantime, he said I was in good health, my lungs were good and there was no hint of any cancer according to my medical records and tests.

The ER doctor, however, did have one disparaging remark. He said my cough could simply be my body going through changes as I age. In other words, he called me old. And there you have it! The ‘old‘ word. The ER doctor didn’t order any tests. Didn’t prescribe me any medication to help with my cough. He just told me that sometimes coughing is something most old people do. Maybe it’s my turn to be old and cough up a bit of phlegm every now and then.

Truthfully, there is no more denying it. However I feel about myself, whatever exercise I do or how healthily I eat, my test results show that my body is aging. And my future with Medicare will be one of total disregard. I’m just a ‘billing money maker’ to both the medical profession and the medical industry.

Just when I thought my life was beginning, I’m facing my potential death.

 

9 comments

  1. I totally agree with you – trust your gut. And – something else I have found to be just as important – I get copies of all my medical/office notes from every doctor/specialist I see. Not just the “summary” they give you when you leave. But after the fact full Office Note. Fascinating to see how what actually happens at an appointment is often not always reflected in my medical record. I always question this – and one GI doc got very flustered and then admitted to using a template that automatically fills in information, such as BP, heart rate, etc. This will then qualify the visit at a higher reimbursement (he didn’t admit that, but it was obvious). This wasn’t Medicare, but I imagine it’s the same. An Electronic Medical Records downside. Never mind that it is dishonest and portrays the patient’s health status in a potentially false and misleading way….and looking back skews the medical history. I also request all test results including the CDs of scans. For one thing I see actual test results & not just the doc’s interpretation or what he/she thinks I should know. Good luck in your search for answers. I hope you find them. It can be such an unnecessary slog. The doctors forget that they work for us!
    (AND the ageism you are dealing with — that makes me crazy too)

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    • Hi Oneletterup. Thank you so much for your comment. I have online media connection to ALL these medical professionals I’ve been seeing. I can’t tell you how many times I have to call them or email them to request they upload the results of my tests to my online accounts! Then I print them out. That’s why my personal printed medical file is several inches high since just this past February. The actual tests or xrays goes onto a CD that I request from their medical records office. And you have to be very careful what you say in front of the doctor. They write down everything! My husband, who always is with me on dr visits, just casually mentioned sleep apnea and immediately it was in my file! with no proof or verification. The doctor demanded that I be tested besides me stating I don’t have it! In every one of my office visits, the doctor secretly tests my mental capability and makes a note of it in my file. Getting old is a very scary thing. I had no idea what challenges I was going to have to face.
      Thanks again for your comment. I’ll keep my readers posted. Everyone seems to think my acid reflex is causing me to cough. I’m seeing the doc for that in 2 more weeks. Fingers crossed.

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  2. I am sorry your health has continued to decline. Hopefully your trip out West will help the breathing—it did me. Just a week in the desert put my asthma in check. Fall is almost here.

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    • Oh Janette, I hope its really true. I’ve been thinking that Arizona may be just the right thing for me. But I don’t think I can keep on coughing till January! UGH. I’ve got two more sets of specialists to see (gastro & thyroid). It’s gotten to the point that I’m afraid to hope anymore. But I do. Finger crossed. 🙂

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  3. I had my thyroid removed in November, 2017 because of a large nodule (goiter). My chief complaint was a bad cough (especially at night when I tried to sleep) You should definitely have your thyroid checked out. Penny S.

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    • Hi Penny. I have. Thank you. I have a parathyroid problem and will probably need surgery. But I didn’t think it would cause a cough. I have an appointment scheduled in a few weeks and I will definitely bring up the coughing subject. You’ve given me new hope because I saw a gastroenterologist today and he wasn’t hopeful.
      Thanks again.

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