Thursday, April 24, 2014
No wonder Rick Scott is Governor of Florida
According to McClatchy, Miami is the capitol of Medicare fraud. This would give him a sizable base that few would contest him for.
If there ever was any question that Miami is the champ when it comes to health care fraud, a peek inside Medicare’s list of banned providers should settle it.Having been a pill mill operator himself, Gov Scott probably moves easily within these circles. And like the Hispanic population, this group is also growing rapidly. But will it be enough to re-elect him?
Of all the people and businesses in the federal government’s “exclusions database,” Miami tops the list – and does so by a long shot, according to a McClatchy analysis.
Of the medical providers in the database, 1,491 list Miami addresses. Second place: Los Angeles, with a relatively meager 522 names. They’re followed by Phoenix; Brooklyn, N.Y.; and Houston in the top five.
“Despite our measurable successes in combating fraud, South Florida continues to be a hot spot of health care fraud and Miami is considered ‘ground zero,’ ” Brian Martens, a federal health care fraud investigator responsible for combating Medicare crimes in Florida, recently told a Senate panel.
To help root out further fraud and abuse, the federal government maintains a “list of excluded individuals/entities,” aiming to provide information to the health care industry, patients and the public about people or businesses currently excluded from participating in Medicare, Medicaid and all other federal health care programs.
As of April, there were more than 57,000 entries on the list.
And more join each year. In fiscal 2013, a total of 3,214 names were added to the database, according to the annual report from the Department of Health and Human Services inspector general. Of those, 1,132 were added because they’d been convicted of crimes related to Medicare or Medicaid, a higher level than at any time in the past 17 years for which records were available.
“A lot of this has to do with greater enforcement, but part also could be an increase in fraud itself,” said Louis Saccoccio, the chief executive officer of the National Health Care Anti-Fraud Association. “In some places, you’ve seen an explosion in health care fraud: in Miami, Houston, Detroit, Southern California. And there is more aggressive law enforcement there. They’re getting convictions, and they’re getting exclusions.”
In Florida, for example, one of the fraud exclusions took place on Feb. 20, 2013, representing one of the final steps in prosecuting a South Florida man who helped run a series of clinics that trafficked in oxycodone and oxymorphone, the powerful pain medications.
Juan De Dios Gomez owned and operated clinics in Hialeah, Miami and Plantation. Federal prosecutors say Gomez and his co-conspirators began their operation as early as November 2007. Physicians who worked at the clinics would prescribe the painkillers for people who didn’t need the drugs but did qualify for Medicare or other health insurance plans.
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