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Medicare fraud under attack to pay for reforms

April 05, 2010

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Medicare fraud appears to be under attack again in an effort to pay for the recently passed healthcare reform legislation. The task forces created to battle the massive fraud that has encompassed the entire country will increase their efforts to investigate and prosecute all violators. The Democratic Congress that recently passed the new legislation has promised to pay for the $940 billion reform by eliminating the fraud, waste and abuse that will amount to $500 billion over the next ten years. Miami will undoubtedly be the first target as reports have consistently targeted South Florida as the main culprit. Criminal defense law firms with experience in handling these matters in federal court will see an upswing in the number of prosecutions sought by the federal government.

Politicians, as well as law enforcement, know that the majority of Medicare fraud comes from Miami and South Florida. Clinic owners, medical supply companies, doctors and patients better be on the lookout as the federal government considers this region ground zero in terms of healthcare fraud. Of all of the home healthcare bills in the country, South Florida is responsible for more than 50% submitted for payment. Some reports indicate that bills were even submitted on behalf of the homeless who provided their names and information for minimal compensation. Another investigation revealed that the federal healthcare system paid for medical equipment and supplies such as hospital beds, wheel chairs and walkers. Many times the equipment was never ordered, necessary, or provided to patients. In fact, some of the companies that submitted bills never existed. In another case, a clinic billed for insulin shots provided to blind diabetic patients, however, the shots were never provided and the patients were neither blind, nor diabetic.

In 2008, prosecutions in the Southern District of Florida skyrocketed. Dozens of individuals were indicted for Medicare fraud that amounted to losses exceeding $792 million increasing to $952 million in 2009. While Miami is the largest perpetrator, health care fraud has found its way to Broward County as well. According to law enforcement authorities, Palm Beach County has been spared in large part due to the ongoing commitment to quashing the problem regarding their neighbors to the South. Proponents of the new legislation believe the crackdown will free up money to compensate for the reform. Significantly reducing the fraud will save hundreds of millions of dollars. The reduction in fraud through enforcement and new legislation will help offset the costs of the new reform bill according to some.

The number of recent prosecutions shows that the federal government is serious in their efforts to minimize healthcare fraud. Earlier this year, six local residents were sentenced in federal court to between 17 months and 25 years in prison for their involvement in a large scale scheme to defraud the federal Medicare system. The men were involved in a scheme to bilk the government out of $50 million. They were paid approximately $19 million for expensive HIV treatments that were never provided to patients. Anyone being investigated for healthcare fraud should immediately seek the assistance of a law firm familiar with these types of cases because the consequences will be serious if the federal government files an indictment.

To Help Pay for Reforms, Medicare Fraud Ripe for Plucking, The Palm Beach, March 31, 2010.

Categories: Fraud
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