Medicare Fraud 'Rampant' In Miami, Spreads Among Different Ethnic Communities Nationally

Main Category: Medicare / Medicaid / SCHIP
Article Date: 08 Dec 2009 - 3:00 PDT

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"Medicare fraud runs rampant in Miami-Dade" while federal experts examine how the crime spreads among different ethnic communities in different cities, The Associated Press/Miami Herald reports. "Miami-Dade County received about half a billion dollars from Medicare in home health care payments intended for the sickest patients in 2008, which is more than the rest of the country combined, according to a report released Monday. The county accounted for a little more than half the country's claims even though only 2 percent of those patients receiving home health care live here, according to a report by the Department of Health and Human Services Office of Inspector General."

"Authorities say it's just another example of Medicare fraud from the county that accounts for more than $3 billion a year in false claims. In some cases, agencies have billed Medicare for home health services for homeless people. ... In many cases, authorities say Medicare is billed for services that are never provided. ... Almost 90 percent of U.S. patients receiving more than $100,000 for home health care live in Miami-Dade County" (Kennedy, 12/7).

Houston Chronicle: "Medicare fraud, like the flu, can be communicable, and authorities have found it spreads among different ethnic communities in different cities. In Houston, the Nigerian community has been most susceptible. In Miami it's the Cuban community; in Los Angeles it's the Armenian and Russian communities; and in Detroit it's the African-American community, according to federal authorities. They caution that these communities are by no means generally corrupt, just like most Italian-Americans were law-abiding citizens decades ago when the Italian mob dominated the U.S. organized crime world. But authorities stepping up Medicare investigations and prosecutions have found what they call 'viral' patterns. ... Lewis Morris, the deputy inspector general in Washington, D.C., who watches Medicare fraud, said the viral patterns happen in close-knit communities because the scams require a number of participants" (Flood, 12/6).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

© Henry J. Kaiser Family Foundation. All rights reserved.

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