High unemployment leads to increased health insurance fraud

Posted on December 10, 2009 3:00 AM EST

Miami Medicare fraud cases have skyrocketed alongside the rising unemployment in South Florida and the United States. Miami criminal lawyers have more than enough Medicare fraud cases to keep them busy these days. The federal government has stepped up efforts to fight the ongoing problem especially in light of the current legislation before Congress. The problem is so bad that affordable healthcare and the healthcare reform legislation are both in jeopardy. By its own admission, the federal government's intense fight to stamp out Medicare fraud had met with mixed results. Experts even say that large high-profile cases are only going to grow because of the new and innovative schemes to defraud that will be seen in the future. If you are being investigated or prosecuted for healthcare fraud, it is imperative to seek a Miami Medicare fraud criminal lawyer with years of experience defending these types of cases.

Many of the Medicare fraud schemes involve identity theft. Identity theft occurs when individuals steal health insurance identification or social security numbers and use this information to obtain healthcare that is not necessary or file false claims altogether. When large groups become involved in this type of healthcare fraud, racketeering (RICO) charges can and will be prosecuted both in state and federal court. People charged with racketeering will receive exceedingly high bonds which may or may not be reduced at a bond hearing. Nebbia requirements usually accompany racketeering charges as well, which require satisfying the prosecution, as well as, the judge, that the proceeds used for the bond do not stem from a criminal enterprise.

In recent news, a Miami clinic for elderly patients was raided by federal law enforcement authorities. They discovered 1,100 medical identification cards that were shared by other clinics and family members. One of those involved in the scheme to defraud pocketed $2.8 million in fraudulent Medicare refunds. Miami is by no means the only city where the fraud is occurring. A New York woman will appear in federal court and is looking at seven years in prison for filing in excess of 50 false claims to her insurance company. Houston and Los Angeles are also hotbeds for this criminal activity.

The South Florida court dockets are well-stocked with Medicare fraud cases. Clinic owners, physician's assistants, receptionists and patients have all been charged in state and federal court. The loss of licenses and businesses are minor problems considering the double digit prison sentences being handed down by courts through the South Florida area. Anyone charged in a healthcare fraud case needs best legal representation with ideal experience in directly handling these types of cases.

Health Insurance Fraud Rising With Surge of Unemployment, exmaxhealth.com, December 7, 2009.