Miami Medicare fraud charges can harm patients, taxpayers, reputable doctors and clinics

Several South Florida defendants are facing federal fraud charges in Miami as part of a raid targeting Medicare scams that cost the government more than $250 million and led to criminal charges against 94 people, the Associated Press reported.

As our Miami criminal defense lawyers have reported here on our Miami Criminal Attorney Blog, federal authorities contend that health care fraud has replaced drug trafficking as the most profitable crime in South Florida. Nationwide, Medicare fraud is a $60 billion crime. Yet, even as the government emphasizes more arrests and prosecutions, just three field inspectors are assigned to all of South Florida. The result can be legitimate doctors, pain clinics and home-health distributors that are unfairly targeted. And fraud can cause havoc for patients as well, when claims are denied because similar services have already been paid as a result of fraud.

In fact, being victimized by Medicare fraud shares many similar characteristics with being victimized by identity theft. Meanwhile, doctors or legitimate business owners who are unfairly targeted as a result of fraud investigations face ruined reputations and the real risk of significant federal prison time.

From kickbacks in the backroom of a Brooklyn clinic, to claims for HIV treatment in Miami that never occurred, to one professional patient with nearly 4,000 false Medicare claims, authorities announced the arrests as a result of a massive investigation. Arrests were made in Miami, New York City, Detroit, Houston and Baton Rouge.

Ninety-four people, including several doctors and nurses, were arrested. While the alleged scams reportedly total $251 million, authorities noted that is just a small portion of the $60 to $90 billion in health care fraud absorbed by taxpayers each year.

For the first time, federal officials have the power to stop paying providers suspected of submitting fraudulent claims, thanks the President Obama’s Affordable Care Act.