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Just Miami – $3B Yr In Medicare Fraud

From an unconcerned Associated Press:

Bernice Brown, right, is escorted from the federal building in Detroit on Wednesday, [June 25, 2009,] following her arrest for Medicare fraud.

Dozens arrested in Medicare fraud busts across US

Kelli Kennedy, Associated Press Writer

MIAMI – Federal authorities arrested 32 people, including doctors, in a major Medicare fraud bust Wednesday in New York, Louisiana, Boston and Houston, targeting scams such as "arthritis kits" — expensive braces that many patients never used.

It’s the third major sweep since Attorney General Eric Holder, Health and Human Services Secretary Kathleen Sebelius announced in May they were adding millions of dollars and dozens of agents to combat a problem that costs the U.S. billions each year.

Using about a dozen agents in targeted cities, including Miami, the Medicare Fraud Strike Force, has recovered $371 million in false Medicare claims and charged 145 people across the country in just two months.

More than 200 agents worked on Wednesday’s $16 million bust that included 12 search warrants at health care businesses and homes across the Houston area.

Federal authorities say those businesses were giving patients "arthritis kits," which were nothing more than expensive orthotics that included knee and shoulder braces. Patients told authorities they were unnecessary and many never used them. But health care clinic owners billed between $3,000 to $4,000 for each kit…

The first task force started in 2007 in Miami, a city authorities say alone is responsible for more than $3 billion a year in Medicare fraud. Clinic owners there would bill Medicare dozens of times for the same wheelchair, while never giving the medical equipment to patients.

The problems have become more complex since then.

Suspects have moved into more sophisticated scams including home health care, physical therapy and infusion drugs. They’ve even started tapping into Medicaid Advantage, which allows the elderly and disabled to get benefits through private health insurers. The plans receive a government subsidy and generally offer more benefits than traditional Medicare.

Federal authorities say Miami residents are also moving on to other cities, bringing their scams with them

In some Miami neighborhoods, the fraud is so rampant that it’s become a cultural norm, with some patients raking in more than $1,000 a month, Kirk Ogrosky, deputy chief of the U.S. Justice Department’s criminal fraud section.

Medicare (not even including Medicaid) fraud already costs the US taxpayer BILLIONS each year?

Just imagine what the numbers will be when Medicaid/Medicare is our national health insurance.

This article was posted by Steve Gilbert on Wednesday, July 29th, 2009. Comments are currently closed.

12 Responses to “Just Miami – $3B Yr In Medicare Fraud”

  1. U NO HOO

    Just isolated incidents.

    Bush’s fault.

    Inherited by Obama.

  2. Yarddog1

    What makes me think that 99% of these people will never serve a day for their crimes? They’ll get a slap on the wrist and be back to doing the same thing in no time. I say make examples of them. Bring back public hangings. They have betrayed all Americans – every last one. Fraud and waste are rampant within these “gubmint” run programs. Medicare would not buy my mother a $300 wheelchair (she’s 88 and cannot walk – numerous strokes and two broken hips), but they did pay $1400 rent on one until the “rent to own” program expired. When I called to complain about this waste the reply was, “well – that’s our policy”. No wonder the system is broken.

  3. wardmama4

    You know what makes me want to cry – my son lost a leg, his fingers on his left hand and because of the scope & depth of his burn – can no longer sweat – so temps over 80^ are a danger to him – and he can not get Medicaid in this state – because we make too much money ($200/yr over their limit) – yet he can’t ever live on his own due to the safety issues that come with losing one’s fingers – and yet a simple $200 is a reason for denial – yet the person in the picture does not appear to be without a leg and fingers.

    So because he can’t live on his own and no I would never, ever condemn him to a group home (all 3 siblings have already stepped up to the plate should the worse happen) – simply to allow him to receive an ‘entitlement’ that due to his disability he should be getting – he’s never going to be able to work at a job that will provide either the benefits or the income to provide for himself.

    It’s not a big deal to us – but it would cover his dental and vision. Which I’m covering his dental and he pays completely out of pocket for his vision. And yet scammers and shammers can get it and people wonder why I’m against Government programs. And yes, if SS, Medicare, Medicaid, Welfare, Food Stamps were cut out today – I’d live with him not getting his check – and covering what we’d have to – as I’m sure our taxes would plummet accordingly.

  4. proreason

    Fraud to you perhaps.

    Redistribution to the people who engage in it.

    Their ancestors, or people their anscestors looked like, were treated poorly you know. Billions is a small step to equalize that injustice.

    • BannedbytheTaliban

      My thoughts exactly PR. Larger control of health care will give the politicians, mostly democrats, another way of redistributing wealth to their constituents, as well as themselves. As for businesses, those that are on board will receive more of the government pie so to speak, that is until a complete take over by the government. Generally speaking government fraud is ignored and written off as playing politics.

      Not that insurance companies are angles either. My over arching questions: what happens when people start to sue the government over refusal of coverage or medical malpractice? How will new drugs and treatments be developed without profits? What is going to happen if you piss off 250 million Americans who are happy with their insurance and who may be denied treatment because it has to go to someone else, someone you are also paying for?

      The real issue is expanding government; Obama cares nothing at all for the average American. Let alone the working poor, those who really can’t pay for insurance. He has contempt for them. It shows in everything he says and does. He made it, why can’t they. After all, isn’t everyone given all the things he has been given?

  5. beautyofreason

    The first task force started in 2007 in Miami, a city authorities say alone is responsible for more than $3 billion a year in Medicare fraud.

    I’m not very good at math, but….

    Miami: 2006 U.S. Census Bureau estimated population of 362,470.

    $3 billion per year in Medicare fraud = $8,276 per person

    Population of the United States: 302,633,000 (2009 Encyclopedia Britannica)

    If one conservatively assumes that the level of fraud under universal health care will be 10% of what took place per person under Medicare in Miami, the amount would total $250,459,070,800 billion nationally. That amount is $827 for every man, woman, and child – more than the annual cost of my private insurance!

    I used a conservative guess. If a national health care system matched Miami in fraud, it would result in over two trillion stolen per year. Of course there are a lot of assumptions here – Miami may be a criminal hot bed for fraud – but even conservative estimates suggest a high amount of abuse and mismanagement in government programs. It’s reasonable to assume that nationalized health care would carry the same risks.

  6. Yarddog1

    I work in the insurance industry. Fraud is rampant, as is frivolous and costly litigation. Take the fraud, abuse and theft (oh – excuse me – incentives for friends, family and “associates”) out of private and public insurance systems and there would be more than enough money to pay for health care, and all your insurance costs and premiums would be reduced as well. Private insurers at least try and minimize the waste while the “gubmint” makes no effort whatsoever to rein in costs and eliminate outright theft.Think about the vast sums of money the “gubmint” programs handle. There are a lot of not so trustworthy hands in the big pot of gold.

    • neocon mom

      To boot, I’ve heard that 73% of every tax dollar that goes to a welfare program is spent on overhead. I doubt private insurance companies could afford to be so inefficient.

  7. Rusty Shackleford

    *sigh*

    Yet another case of “cops acting stupidly”.

    (shaking head) Such a shame, such a shame.

    • Liberals Demise

      Now, Now Rusty!!
      Let’s not be too judgmental about gubbamint health care till all the money disappears!!
      You gotta job right?
      Then …… your rich!!

  8. joeblough

    This isn’t hard. It isn’t complicated.

    More government control = more opportunity for fraud & corruption

    Less government control = less opportunity for fraud & corruption

    The number of people who will use opportunities for fraud & corruption tends to remain fairly constant.

    You do the math.

  9. MinnesotaRush

    Were these law enforcement agencies profiling? Better check with Prof Gates, huh.

    How much ya’ wanna bet this gal in the picture has an ACORN T-shirt and coffee mug at home?


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