Health care fraud an increasing concern in Miami and throughout Southwest Florida

Medicare and health care fraud in Miami continues to victimize consumers and taxpayers. However, unfair allegations can also be devastating to legitimate heath care providers who are unfairly targeted by overzealous investigations.

The evidence of fraud is readily apparent: just this week, the operator of a South Miami-Dade medical clinic faced 10 years in prison on federal fraud charges accusing him of a scheme to bill Medicare $5.8 million for HIV therapy that was never provided to patients, according to the Miami Herald.

The paper reports the SW 124th Street clinic was typical of many that have flourished in Miami in recent years, billing billions of dollars to Medicare for fraudulent treatment claims. Instance of home health care supply stores filing fraudulent claims from strip mall storefronts continue to surface across South Florida.

A 60 minute expose last fall reported that health care fraud has replaced drug trafficking as the most profitable crime in South Florida. Nationwide, Medicare fraud is a $60 billion crime.

If you think that means the government is throwing its weight behind investigating fraud allegations, that is not necessarily the case. A total of just three field inspectors are assigned to all of South Florida. An emphasis on prosecution, without the necessary support for investigation, means legitimate doctors and medical providers are at increased risk of being targeted by inadequate investigations.

And patients can be victimized in cases where a fraudulent operator obtains stolen patient lists from a doctor’s office. Elderly or disabled patients continue to struggle to get approved medical devices in instances where someone has already fraudulently submitted a claim for the same device using their name and medical information.