The Economist recently reported on a $251 million plot it describes as the “largest federal health-care fraud takedown in our nation’s history.” The report said 94 people in five cites were charged with Medicare and Medicaid fraud.
Citing a report by the non-profit Coalition Against Insurance Fraud, the Centers for Medicare and Medicaid Services lose more than $60 billion a year to scam artists, the report said.
One third of the money in all prosecuted cases took place in South Florida where FBI experts on organized crime are now being involved. The region’s reputation for Medicare fraud is “mind-boggling,” the Economist reported, noting that Florida mental-health clinics submitted $421 million in Medicare bills last year – four times the amount coming from Texas. The article mentioned further, “A shocking proportion” of Medicare fraud in Florida “is conducted by Cuban exiles, just-arrived and penniless, who quickly amass vast fortunes.”
Meanwhile, the Huffington Post earlier reported on government’s recovery of $2.5 billion in overpayments for the Medicare trust fund in 2009. Citing new tools used by investigators, the report said there is “a rising number of criminal prosecutions and the return of more stolen money to the government.” Investigators are also “blocking unscrupulous companies from getting into government health care programs in the first place,” the report added.
The Post also mentioned that the Justice Department and Department of Health and Human Services are concentrating their efforts in curbing Medicare fraud in south Florida, Los Angeles, Houston, Detroit, New York City’s Brooklyn borough, Baton Rouge, La., and Tampa, Fla.
Medicare fraud and billing errors costs the government more than $36 billion last year, the Economist noted. The modus operandi involves a “care-provider” billing Medicare for non-existent or unnecessary services. These services and items include: HIV/AIDS medicines and therapy; medical equipment such as wheelchairs to neck and knee braces, as well as home health care, physical and occupational therapy and mental-health services.
The newly enacted Affordable Care Act provides $300 million to government agencies in the forefront against Medicaid and Medicare fraud. The Act also lengthens prison sentences and gives the government new authority to oversee companies participating in Medicare and Medicaid. “We’re going to attack fraud at every stage of the process,” Health Secretary Kathleen Sebelius told the Post.
© 2010 Micmn.com. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. Learn more about our Privacy Policy and Terms of Use.
Recent Feedback