Medicare fraud: A continuing problem

July 15, 2010

Despite the effort, man power, and millions of dollars being thrown at Medicare fraud, the federal government does not have an answer to the problem. South Florida and Miami Medicare fraud cases continue to exist despite the extensive operations of federal law enforcement investigators. As the fed clamps down, new areas are being targeted for fraud. Medicare is now being billed for fraudulent mental health and physical therapy treatments. Physical and occupational therapy schemes appear to be replacing the fraudulent billing for medical treatment and medical equipment. As concerns grow, the attorney general and the secretary for Health and Human Services will hold a healthcare fraud summit in Miami.

The head of the Medicare strike force for South Florida and the Miami area reported that the majority of Medicare fraud cases are still fraudulent billing for medical treatments for HIV patients, home healthcare for diabetics and billing for medical equipment, however, new types of cases are arising from billing by shady mental health centers. According to the director of Medicare in South Florida, the pressure placed on the medical clinics has caused them move to more fertile areas such as mental health and rehabilitative facilities. Just last year, rehabilitation facilities in South Florida billed Medicare approximately $171 million which significantly higher than California and New York. Despite the shift in strategies, it is apparent that Miami criminal defense lawyers will be defending clients charged with Medicare fraud in federal court for years to come.

Medicare fraud is expected to cost taxpayers approximately $68 billion next year. If the federal government ever gets its act together, it will like seek to shut down many clinics and health care facilities. Despite losing the battle, the Medicare fraud strike force has continued to investigate and the U.S. Attorney''s Office continues to prosecute these offenses. Since Medicare fraud became targeted in 2005, approximately 1,000 defendants have been prosecuted in South Florida and Miami for filing almost $3 billion in fraudulent bills. Whatever the angle may be, those who engage in Medicare fraud use the same tools such as kickbacks to patients, billing for unnecessary procedures and equipment and submitting fraudulent billing codes to skirt Medicare's technology.

Some experts blame the ongoing problem of Medicare fraud on the growing number of immigrants into the United States. The experts also believe that individuals turn to healthcare fraud because they believe the punishment for white collar crimes is less severe than punishments for violent crimes or drug trafficking offenses. Defendants charged with Medicare fraud and other white collar crimes should be aware that the penalties for these types of offense can even be more harsh. The penalties for white collar crimes always depends on the amount of the loss. That being the case, a person committing large scale healthcare fraud can receive a harsher sentenced that an defendant charged with cocaine trafficking.

Magnitude of Medicare Fraud in South Florida Grows, The Miami Herald.com July 13, 2010.