Miami-Dade Ground Zero for Medicare Fraud and Abuse
Federal investigators consider Miami-Dade County ground zero for Medicare fraud and abuse cases.
According to CNN, federal agents recently shut down operation of five separate rings that allegedly filed $61 million in false claims with Medicare, and charged 32 people in Miami, Detroit, and Brooklyn.
The individuals allegedly were involved in a variety of schemes to defraud the health care system for the elderly and disabled.
They are charged in indictments including conspiracy to defraud the Medicare program, conspiracy to launder money, money laundering, criminal false claims, making false statements and receiving kickbacks.
The largest case, in Miami, involved a doctor and nurses who allegedly ordered home health care services that were not medically necessary.
Officials say medicare fraud and abuse cases boils down to stealing American taxpayer dollars that are intended to go to those most in need.
The inspector general found that 52 percent of all Medicare home health care expenses above $100,000 were in Miami-Dade County, while only 2 percent of Medicare home health care beneficiaries actually live in that county.
Medicare fraud cases have become one of, if not the most profitable, crimes in America.
Attorney General Eric Holder has said more oversight is needed and recently announced the formation of the Health Care Fraud Prevention and Enforcement Action Team (HEAT). A multi-government agency, HEAT works to stop providers, doctors and other individuals from abusing the Medicare system.
Currently, HEAT is looking to set up up in Baton Rouge, Louisiana, and Tampa, Florida, to complement strike force operations already in place in Miami, Los Angeles, California; Houston, Texas; and Detroit.
- Medicare Fraud: A $60 Billion Crime (CBS)
- Medicare Fraud Overview (The Official U.S. Government Site for People with Medicare)
- Medicare Fraud Strike Force Expands Operations into Brooklyn, N.Y.; Tampa, Fla.; and Baton Rouge, La (US Department of Justice)
- Medicaid v. Medicare (provided by Chayet & Danzo, LLC)
- Criminal Prosecution for Medicare and Medicaid Fraud (provided by Law Offices of Jeffrey C. Grass)