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Dozens arrested in medicare fraud case

Posted on September 07, 2011 3:00 AM EST

Federal law enforcement authorities arrested 42 people alleged to have committed Medicare fraud throughout hree counties in the South Florida area. Among those arrested were the owners of the Biscayne Milieu Health Center, a psychiatrist from Broward County, along with patient recruiters and assisted living facility landlords. Other defendants arrested in the case and accused of the fraud include home healthcare perators, HIV clinics owners and operators and medical equipment suppliers. In total, the purported criminal enterprise billed Medicare in excess of $160 million for medical services that were not necessary or in some instances never even provided to patients. Medicare paid out approximately $90 million. Broward and Miami criminal defense lawyers, either appointed by the court or privately retained will represent the defendants in the case.

According to government officials, this alleged Medica fraud scheme was a bit different from those seen in the past. It is alleged that recruiters lured out-of-state patients to the South Florida and Miami area with the promise of giving them housing and a fresh start. Instead, the patients brought their Medicare cards with them and were placed in substandard assisted living facilities. The patients were also directed to attend mental health programs and group therapy sessions which would also be billed to Medicare. If the patients refused treatment they were kicked out of the ALF's and forced to live on the street.

The federal government continues to vigorously investigate and prosecute Medicare fraud cases in cities such as Miami, Brooklyn, Detroit and Los Angeles. Forty million people a year claim benefits, but the program has suffered billions of dollars in losses as a result of fraud, waste and abuse. With politicians and the federal government under the gun for losses incurred in the federal healthcare system, a new computer software program was initiated with the hope that the losses could be curtailed. The new program is said to be a proactive approach to defeating fraud, however, investigators claim the program is inadequate and that the federal government will continue to combat fraud after it has been committed.

Anyone being investigated for or having been arrested on these types of fraud charges must seek out legal counsel as soon as possible. Defendants charged in healthcare schemes to defraud are facing significant terms of incarceration because of the amount of losses suffered by Medicare. While fraud is a relatively low offense under the federal sentencing guidelines, the offense becomes much more severe when the losses accrue in excess of a million dollars. Owners and operators of clinics involved in illegal billing are also subject to multi-level increases if it determined that they were the leaders of organizers of the fraud. In any event, the feds continue to investigate and hunt down all those alleged to be involved in these types of criminal enterprises.

Medicare Fraud Case Nets Dozens of Arrest, Miami Herald.com, September 7, 2011.
Categories: Fraud