Fight Medicare Fraud

WE HAVE TO FIGHT AGAINST MEDICARE FRAUD!


The Miami Herald reported again several troubling cases of Medicare fraud
The stories are very familiar:
• A family-run enterprise of medical equipment and billing companies submitted more than $17 million in false claims to Medicare, they admitted in court. Their haul: $5 million. The family's scheme was launched in 1999, when David and Laura Hernandez opened their first medical equipment company, said Assistant U.S. Attorney Ryan Stumphauzer.In a statement filed in court, the three admitted opening a string of equipment suppliers in Miami-Dade and starting a billing company to file false claims with Medicare. The billing company was owned by Laura Hernandez. David Hernandez, in the lead role, recruited four people to register as the official owners of four equipment-supply companies to conceal his participation in the scam, according to the court statement. Those ''nominee'' owners, members of another family, were charged in a separate Medicare fraud indictment. Husband and wife Jose Echevarria and Magaly Martinez, along with their son, Yuniel Echevarria, and his wife, Suyima Torres, pleaded guilty earlier this year. To fuel the racket, David Hernandez and his brother, Jose, paid kickbacks to patients for the use of their Medicare numbers. In turn, the brothers billed the federal insurance program for products, such as beds, catheters and pumps, that were never delivered to anyone. Proceeds of the fraud were deposited in the corporate bank accounts of the family's medical equipment companies. Hernandez also laundered some of the Medicare reimbursements through shell companies with ''medical-sounding'' names that were set up to cash checks at banks so his family could pocket the proceeds, according to the statement filed in court. Some of that taxpayer money enabled the Hernandezes to pay $331,000 to buy the Pembroke Pines home in 2002.
• A Miami doctor and nurse have been convicted of billing Medicare for millions of dollars in false claims for obsolete HIV therapy at a local clinic owned by three brothers who fled to Cuba to avoid prosecution. Dr. Ana Alvarez-Jacinto and Sandra Mateos, found guilty by a Miami federal jury Friday, played key roles in an $11 million scam involving HIV-positive patients who received kickbacks in exchange for letting the clinic use their Medicare numbers to bill the federal program. The two women who opened St. Jude Rehab Center as partners with Carlos, Jose and Luis Benitez -- fugitives charged in a separate indictment -- had already pleaded guilty to fraud this year. Mariela Rodriguez and Aisa Perera, who ran St. Jude from June to November 2003, collected $8 million from the false Medicare claims.
• A local physician convicted of Medicare fraud for his role in a massive HIV therapy racket run by three Miami-Dade brothers was sentenced to seven years in prison on Tuesday. Ronald Harris, 58, wrote prescriptions to bill Medicare for an obsolete treatment that was not provided to patients with the virus that causes AIDS, according to court records. The patients received cash kickbacks in exchange for letting the Miami physician bill the federal health insurance program with their Medicare numbers.In August, Harris pleaded guilty to a conspiracy charge as the medical director for Physicians Med-Care in Miami and Physicians Health Med-Care in Hallandale Beach. The two HIV clinics submitted $26.2 million in false claims to Medicare between 2002 and 2004.

Lets be reminded that EVERY DOLLAR embezzled by this crooks is one dollar less paying for legitimate medical services rendered by had-working honest doctors!
Therefore, we need to be on alert pointing out fraud and abuse whenever it occurs in our community. No, we are not snitches but responsible members of our community who care for the viability of the Medicare program.
We need to work together on that and other issues. Together we are stronger. Together we can address this challenge.