By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
On April 28, 2016, agents from the Federal Bureau of Investigations (FBI) arrested 21 suspects on charges of operating Miami-Dade pharmacies as fronts to steal $17 million from the Medicare program. Four additional suspects are believed to have fled to Cuba, where Medicare fraud fugitives have found refuge for years. The immediate question is that with political relations with Cuba easing up, how much longer are crooks going to be able to do this? Hopefully, not much longer.
String of Local Pharmacies Used as a Front.
In September 2015, FBI agents showed up at Hialeah dental office looking for the alleged ringleader of the Medicare fraud scam. He managed to slip away before authorities could make an arrest and he and three others are believed to have escaped to Cuba.
But on April 28, 2016, 18 other members of his network were not so lucky. They were arrested and charged with operating the Miami-Dade pharmacies as a front to defraud the Medicare program of $17 million.
Federal agents and special agents of the Department of Health and Human Services (HHS) Office of Inspector General (OIG) spread out to arrest the suspects. The suspects who were arrested are also charged with conspiring to defraud the federal health insurance program by paying off recruiters to reel in Medicare beneficiaries so they could use their ID numbers to file false claims for prescription drugs, according to authorities.
Multi-Million Dollar Scheme.
Authorities state that the suspects were able to pull off the multi-million dollar scheme by forging doctors’ signatures for medication that was either unnecessary or not provided. Because of a longstanding problem of lax oversight by federal health care regulators, Medicare and private insurers failed to detect the fraud after paying out millions. “Unfortunately, South Florida remain ground zero for these types of scams,” said William Maddalena, assistant special agent in charge of the FBI’s Miami office.
A Longstanding Problem.
Pharmacy fraud has become increasingly common in Florida, the nation’s perennial capital of Medicare fraud. In several recent cases, pharmacy owners paid kickbacks to patients or patient recruiters to generate a steady stream of false Medicare claims and bilk the Part D program. To read one of my prior blogs on a similar case of fraud in Florida, click here.
Fleeing Criminals Take Our Taxpayer Money to Foreign Countries.
This seems to be a recurring theme. In every big arrest of multiple conspirators and Medicare fraudsters, there seems to be a bunch who have fled oversees. Even in our dealings with pain management clinics, it is often discovered theat millions of dollars have been sent by the nonphysician owners overseas, beyond government reach. In Florida, the fugitives’ haven seems to be Cuba more often than not. It is our hope that the U.S. is making headway in its thawing of relations with Cuba, to reach an agreement with Cuba to be able to extradite these fugitives and seize their assets. While Cuba remains a poor, embargoed country, this is unlikely to happen. When it can see billions in tourist and investment dollars at stake, it will be a different story. Why should we allow criminals to sit 90 miles offshore with their stolen millions and thumb their noses at the rest of us, when the “good” criminals would rather live in federal prison than live in Cuba?
Don’t Wait Until It’s Too Late; Consult with a Health Law Attorney Experienced in Medicare and Medicaid Issues Now.
The attorneys of The Health Law Firm represent healthcare providers in Medicare audits, ZPIC audits and RAC audits throughout Florida and across the U.S. They also represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions and termination from the Medicare or Medicaid Program.
For more information please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or (850) 439-1001.
Weaver, Jay. “FBI agents bust Miami Medicare ring while some suspects flee to Cuba.” Miami Herald. (April 28, 2016). Web.
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.
KeyWords:Medicare fraud, Centers for Medicare and Medicaid Services (CMS), pharmacy, Florida pharmacy investigation, false claims, Office of Inspector General (OIG), Department of Health (DOH), U.S. Department of Health and Human Services (HHS), pharmacy raid, defense attorney, defense lawyer, pharmacist defense, Medicare fraud defense lawyer, Legal counsel for pharmacists, Florida pharmacy defense attorney, Florida health care attorney, Florida health care lawyer
The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
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