Another day, another medicare fraud bust

Posted on October 25, 2010 12:00 AM EST

Federal law enforcement has charged four South Florida residents for their involvement in a multi-million dollar Medicare fraud scheme. According to the indictment, four healthcare operators attempted to bilk the federal healthcare program out of $200 million for medical services they did not perform. The indictment accuses four Miami-Dade County residents of being linked to American Therapeutic Corporation. The company's owner, chief executive officer and two other employees were taken into custody last week. American Therapeutic is the largest chain of clinics supported by the federal healthcare system. The defendants will make their initial appearance with their privately retained Miami criminal defense lawyers or attorneys from the federal public defender's office.

The indictment alleges that the company and the defendants charged Medicare on behalf of Alzheimer's patients for treatments that were not necessary or in most circumstances for treatments that were not even provided. Most of the purported healthcare recipients were referred to American Therapeutic by assisted living facilities (ALFs) in exchange for monetary kickbacks, The Medicare fraud case cost losses in excess of $163 million to the federal healthcare system and is one of the largest fraud cases on record. Like the other large fraud cases in recent history, The Medicare Frauds Strike Force was at the heart of the investigation.

Despite the media attention that the offenses of Medicare fraud and healthcare fraud, in general, have gathered due the long list of arrests and convictions, it has not dissuaded individuals from continuing a criminal course of conduct. The Justice Department holds press conferences after every major bust, but despite the dissemination of the information, Medicare fraud continues to exist. According the newest press release, the federal government will continue to fight the ongoing fraud at all costs. Last month, President Obama signed a new law requiring Medicare requiring the use new technology to flag suspicious activity rather than just paying out the billing requests. Until the recent law was passed, Medicare paid out bills without verifying whether or not the bills were fraudulent or not.

The federal healthcare system has been required to place a watch on many Miami-Dade clinics, as well as, clinics located in New York and Los Angeles where the majority of the fraud cases originate. Why is Miami a target of healthcare fraud? Last year alone, more than 100 clinics, the majority of which are located in Miami-Dade County submitted in excess of $425 million dollars in bills to Medicare. Fifty-six percent of all payments from Medicare were made to South Florida clinics, with the majority being in Miami, Broward and Palm Beach Counties. Anyone being investigated for or that has been arrested for Medicare fraud, should immediately retain a Miami criminal defense law firm specializing in defending healthcare fraud cases in federal court.

Federal Agents Round Up Ring of Mental Health Operators in Alleged $200 Million Medicare Fraud Case, The Miami Herald.com, October 21, 2010.