Crossing the Line

64

Unfortunately, a lot of health care fraud occurs in the State of Florida. One reason for the high rate of fraud is because the Sunshine State has a very large pool of Medicare and Medicaid beneficiaries to victimize. An article posted on NBCMiami.com tells the story of a recent raid on a Florida health care company and 11 employees that may have gone beyond state and national borders to recruit victims for their alleged $25 million health care scam. (Perhaps the alleged perpetrators thought that the crime would be harder to track down if the victims were from another country.)

The story states that the alleged perpetrators recruited people living in the Dominican Republic and Nicaragua to apply for Medicare and Medicaid benefits, stating that they were Florida residents. Both government programs made payments to the Florida health care company based on claims submitted by the fraudulent Florida residents.

The article also says that according to the federal indictment, the Florida Medicaid program paid Medicare premiums and deductibles for multiple beneficiaries who did not actually live in Florida. (It is also alleged that co-conspirators included primary care doctors who saw the patients and provided diagnoses for the defendants so they could bill Medicare.)

It is important to remember that the 11 defendants, who are charged with a number of counts of health care fraud, are innocent until proven guilty in a court of law. No matter the outcome of the case, this recent raid proves that law enforcement officials in Florida are serious about battling health care fraud no matter the location – whether local or across state and even national borders. The government will continue to go after those people who cross the line by threatening the country’s health care system and the beneficiaries who rightfully deserve assistance.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”11 Charged in Medicare/Medicaid Fraud Scheme,” posted on NBCMiami.com on November 19, 2014.

Federal agents raided Florida Healthcare Plus in Coral Gables Wednesday for allegedly running a more than $25 million Medicare, Medicaid, and wire fraud scheme.

Authorities said eleven people were involved in the schemed to defraud the government. According to the federal indictment, Florida Healthcare Plus (FHCP) was authorized by Medicare and Medicaid to offer plans to the beneficiaries, which was then allegedly taken advantage of by the defendants.

Read More

SHARE
Previous articleNothing Is As It Seems
Next articleUsed Fraud Salesman

Larry Benson, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.