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$260m US medicare fraud, 90 people arrested

14 May 2014, 12:19

Miami - Ninety people, including doctors, pharmacy owners and elderly patients, were arrested this week in six cities and charged with submitting fake billings to Medicare worth nearly $260 million, federal officials said on Tuesday.

"They each tried to use the Medicare programme as their own personal ATM machine and to line their pockets with our money," US Attorney Wifredo Ferrer told reporters.

Since 2007, when federal agencies stepped up efforts to crack down on Medicare fraud, authorities have arrested and charged more than 1 900 people who collectively have falsely billed more than $6bn to the government health programme for the elderly and disabled.

A majority of the recent arrests were made in south Florida, which has emerged as a hotbed of Medicare fraud.

'Excessive claims'

Among those arrested this week was an 85-year-old man on Medicare who allegedly received kickbacks in exchange for ordering home healthcare services.

Eduardo Perez de Morales, aged 26, was charged with laundering the proceeds of healthcare schemes through a remittance company that sent money to Cuba.

Arrests were also made in Detroit, New York City, Los Angeles, Houston and Tampa.

The schemes used to bleed millions from Medicare ranged from recruiters paying elderly individuals to file excessive claims to home healthcare agencies seeking payment for services never performed and medical supply companies billing for equipment that was never ordered, officials said.

Yet the greatest concern was raised over fraud in Medicare Part D, which provides drug benefits for elderly and disabled people through private insurers.

"We find ourselves to constantly be engaged in a game of whack-a-mole," Ferrer said. "These small pharmacies, which some people can actually describe as holes-in-the-wall are actually billing a lot more to Part D than major national chains."

- Reuters


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