How much Medicare fraud occurs in Florida?

On Behalf of | Dec 16, 2021 | Blog, Medicare and Medicaid Fraud

According to a press release issued by the US Attorney’s Office for the Southern District of Florida on Sept. 17, 2021, South Florida is “ground zero” for health care fraud.

During one 6-week enforcement period earlier this year, the government brought charges against 52 Florida residents for alleged schemes falling into the following three broad categories:

  1. Fraud related to the pandemic
  2. Fraud related to substance abuse treatment facilities
  3. Traditional Medicare fraud

Pandemic cases

In one case brought against a Miami resident, prosecutors allege that he stole N95 masks and other medical products from his place of employment which he then sold to various purchasers, some as far away as California, for $55,000.

Sober homes cases

Two residents of West Palm Beach face charges of conspiring to commit $128 million in health care fraud related to their ownership of a substance abuse treatment center and several drug testing laboratories. Per the charging document, they hired a physician to direct their treatment center. He, in turn, signed orders for expensive and unnecessary drug tests, which he billed to the unsuspecting patients’ insurance plans, in exchange for patient referrals. The defendants then had their labs perform the tests and received kickbacks from them.

Traditional fraud cases

Additional cases brought against Florida residents allege a wide range of more traditional Medicare fraud involving the following:

  • Durable medical equipment
  • Home health care
  • Telemedicine
  • Pharmacies
  • Kickbacks
  • Money laundering

During the past fiscal year that ran from Oct. 1, 2020, through Sept. 20, 2021, the government charged 196 Florida defendants with allegedly billing $2.2 billion in fraudulent claims, resulting in payments totaling $488 million.

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