$100 Million of Medicare Fraud Found in Miami

06/24/2009
By Sophie Callahan

Eight defendants were recently charged in an elaborate scam that involved billing Medicare for fake HIV and cancer infusion drugs. The fraud spanned the five states of Florida, North Carolina, South Carolina, Georgia and Louisiana and used 29 fake storefronts in order to attempt to steal $100 million from Medicare and Medicare Advantage. Two of the defendants, along with about $30 million are still missing.

Most Medicare fraud cases are easy to detect through investigating the money involved in bank transfers. However, this case was a little harder to track because the group owned two check cashing stores where they would cash between $30,000 and $80,000 several times a week. In order to deter authorities from the fraud, the defendants varied whose name the companies were kept under. If the defendants are convicted, they could face up to years in prison on each count of conspiracy, healthcare fraud and money laundering, and up to two years for each count of aggravated identity theft.

Medicare fraud is common in Florida due to things like its easy access to other countries as an escape route. In the past three years, $1.5 billion in health care fraud cases have been prosecuted. Miami single-handedly had 146 convictions since 2007 in Medicare fraud cases. This case exemplifies the crackdown on Medicare fraud. It was one of the fastest health care fraud turnabouts: it only took two months from the tip to the indictment. This shows that people are becoming more aware of the problem and trying to solve it.

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