Medicare Screwed? Fraud? Just Another Day in California Medical System!

A story for you that is hard to believe. It starts sad and then it becomes really ugly so stick with me until I get to the point. My mom died in April and of course, lots of malpractice, incompetence, ignoring power of attorney, wrong drugs without permission, etc. These stories for another day but I now want to introduce you to another subject.

My mother belonged to a large HMO through a major senior organization in Southern California–not giving names but I am sure you know what I am talking about. Few seniors do not belong to this HMO. After my mom died and I received all the medical records from all the hospitals, skilled nursing, etc.,  (for a lot of money mind you!) I started to suspect that something is not right.

Today I received a call from another woman who went through the same thing–with the same hospital in one case–with the same outcome: dead mother for no reason. She had something I did not have: Medicare summary copies of medicines and treatments her mother received so she could see that there was fraud. The hospitals charged Medicare for things her mother (blind and demented) could never do, medications she never got, etc.

She tried everything and though she could not break the system, she educated me on what so far she has learned. Well. Let me tell you this is not pretty!

On her urging I called the Senior Medicare Patrol in Orange County who dutifully will investigate all charges that were submitted by individuals to examine hospitals and medical providers in what they submitted to Medicare and then compare those with the data files of the patients to find discrepancies–sort of like a Medicare watchdog. Awesome. Great service! So after we talk, I called Medicare and gave them my mother’s information and asked them to send me the medicine and treatment records they have from the hospitals so I can compare what she got versus what was claimed on the medical records and then, like an autumn fly, I hit the hard wall of stupidity.

I call it ADA, short for “absolute dumb act,” on the part of both Medicare and also on the part of the California legislature.

First let’s look at Medicare’s dumb act: when someone dies, Medicare immediately purges all records so there is no chance in heaven or hell to find out what medications and treatments were claimed by hospitals or doctors and what the deceased actually received. This is an amazing opportunity for fraud and I bet your pants off that there is plenty of fraud as a result. There is just simply no way to check who received what and what was claimed–this is invitation to cheat as you like.

Dumb act two is even dumber: HMOs file to Medicare in “bulk” meaning that if they have 15 patients who receive morphine, they will bill Medicare for 15 doses of morphine but Medicare will have no clue who actually received that morphine–perhaps no one did! So in theory, any HMO hospital or medical center can claim any amount of any expense of any drug given to any patient for reimbursement that they have never ever given to anyone

Are you angry? You must be! It is your money these HMOs are taking! It is your tax dollars they are spending–no wonder our government is bankrupt! I will open my window and yell as “I am mad as hell and will not take it anymore!” until I can get the ears of someone who can help me change the system!

If you have information of any kind that is helpful so I can start breaking the system down, please send a note, email, comment, whatever. I want this ADA to end!


About Angela A Stanton, Ph.D.

Angela A Stanton, PhD, is a Neuroeconomist focusing on chronic pain--migraine in particular--physiology, electrolyte homeostasis, nutrition, and genetics. She lives in Southern California. Her current research is focused on migraine cause, prevention, and treatment without the use of medicine. As a forever migraineur from childhood, her discovery was helped by experimenting on herself. She found the cause of migraine to be at the ionic level, associated with disruption of the electrolyte homeostasis, resulting from genetic variations of all voltage dependent channels, gates, and pumps (chanelopathy) that modulate electrolyte mineral density and voltage in the brain. In addition, insulin and glucose transporters, and several other variants, such as MTHFR variants of B vitamin methylation process and many others are different in the case of a migraineur from the general population. Migraineurs are glucose sensitive (carbohydrate intolerant) and should avoid eating carbs as much as possible. She is working on her hypothesis that migraine is a metabolic disease. As a result of the success of the first edition of her book and her helping over 5000 migraineurs successfully prevent their migraines world wide, all ages and both genders, and all types of migraines, she published the 2nd (extended) edition of her migraine book "Fighting The Migraine Epidemic: Complete Guide: How To Treat & Prevent Migraines Without Medications". The 2nd edition is the “holy grail” of migraine cause, development, and prevention, incorporating all there is to know. It includes a long section for medical and research professionals. The book is full of academic citations (over 800) to authenticate the statements she makes to make it easy to follow up by those interested and to spark further research interest. It is a "Complete Guide", published on September 29, 2017. Dr. Stanton received her BSc at UCLA in Mathematics, MBA at UCR, MS in Management Science and Engineering at Stanford University, PhD in Economics with dissertation in neuroscience (culminating in Neuroeconomics) at Claremont Graduate University, fMRI certification at Harvard University Medical School at the Martinos Center for Neuroimaging for experimenting with neurotransmitters on human volunteers, certification in LCHF/ketogenic diet from NN (Nutrition Network), certification in physiology (UPEN via Coursea), Nutrition (Harvard Shool of Public Health) and functional medicine studies. Dr. Stanton is an avid sports fan, currently power weight lifting and kickboxing. For relaxation (yeah.. about a half minute each day), she paints and photographs and loves to spend time with her family of husband of 45 years, 2 sons and their wives, and 2 granddaughters. Follow her on Twitter at: @MigraineBook, LinkedIn at and facebook at
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5 Responses to Medicare Screwed? Fraud? Just Another Day in California Medical System!

  1. How very interesting and disgusting Angela, you sure are amazing, I admire the work you are doing here..hope it helps…

    Liked by 1 person

    • Thanks Sherri and thanks for the re-blog. I hope I will be able to turn the medical system around… It will be hard work and cannot do it alone but by gully I will give it my best try! ❤


  2. Angela Grant says:

    Angela I think the clueless people are not doctors but rather patients. Clueless patients trust our medical system. provides care. Clueless patients have not discovered the deep depths of corruption and incompetence baked into our medical delivery system. A system culturally incentivized for more fraud and abuse by quacks such as Sunil Shroff, MD at Tufts Medical Center and Alice Newton, MD at Boston Childrens now promoted to MGH.

    The doctors are being paid quite well by patients (US). As a matter of fact, hospitals and their staff are being given more POWER so I would say we are clueless in letting this continue.

    Everyone should take care of her health and pray never to need the services of our medical system.

    Liked by 1 person

    • Totally agree Angela. I titled the blog clueless doctors to bring attention to the cluelessness of the doctors to themselves! The final book will mostly be educating the public. There will be some stories on how and why doctors are clueless. Not all doctors are so though but the gems are very hard to find.

      But listen to this: I filed a complaint against a doctor that the state licensing investigator of a skilled nursing found by accident to have lied to them about how I approved something–no paper trail of course, since I never approved it–so in the process I found out that this “doctor” does not even have a license to practice! Now we are not talking about a small unknown medical facility here but one of the biggest ones in the state! So I filed a complaint with the CA Medical Board and they “confirmed” that they received my complaint against the doctor under whose license this guy was pretending to be a doctor and not this guy! I just wrote them a letter by fax (for the paper trail) back to the Board that oh no you don’t!!! I want the complaint against BOTH doctors since both have committed a crime! They both better end up without license forever and the one prescribing without license better be having visiting hours in jail!

      So while the general public is clueless about the medical field’s incompetence, the medical field is also clueless and is criminal in more ways than one. All this and more in my book! (I am mad as hell in case you cannot judge from my tone of voice! Grrrrrrrrrrr)

      Liked by 1 person

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