Rampant Medicare fraud suspected in Miami

[Ban Hammer 14,292]

By Julie Appleby, USA TODAY

Home health care costs charged to Medicare in the Miami area have risen 20 times the national average in the past five years, prompting a federal investigation of suspected fraudulent billing.

Miami-Dade County is on track to cost Medicare a projected $1.3 billion for home health care services this fiscal year, up 1,300% in just five years, government data show.

Investigators suspect that fraud is helping to drive the increase because the population of Medicare beneficiaries in the county grew only 10.2% between 2004 and 2007, the latest government data show.

"You definitely have a problem down here," says Randall Culp, an FBI supervisory special agent who oversees a team that works with a Medicare Fraud Strike Force in Miami.

In South Florida, investigators say, some agencies are billing Medicare for millions of dollars in services that are unnecessary, overused or not provided at all.

Investigators elsewhere are paying attention because South Florida is a bellwether for scams that later surface in other large cities, such as Los Angeles and Houston. Scams involving fake AIDS treatments, for example, popped up in Detroit and several other cities after a crackdown in Miami, Culp and others say.

"Typically, Miami is ground zero. Then we see it move to the other high-fraud areas," says Suzanne Bradley, an investigator with the Centers for Medicare and Medicaid Service's field office in Miami.

Home health agencies send nurses and aides to assist homebound elderly and disabled beneficiaries. Nationally, Medicare expects to spend $16.5 billion on home health care this year, up 65% from five years ago.

Medicare spent six times more on home health care services in Miami-Dade County during the first five months of this year than in Los Angeles County, where the Medicare population is three times larger, agency data show.

"It jumps off the page as out of proportion," says Kirk Ogrosky, deputy chief in the Criminal Division's Fraud Section of the Justice Department.

Today, acting Medicare chief Kerry Weems says he will announce new anti-fraud efforts, some targeted at home care agencies in Miami.

"It does affect everyone because everyone is paying into Medicare," says Peggy Sposato, a nurse investigator with the U.S. attorney in the Southern District of Florida, who combs through data looking for unusual billings.

link

[Hilarious Clinton 452]

Time to prosecute.

[HAL 9000 96]

We should blame Republicans. They seem to run Miami.

j/k

That and all the phony medical licenses there... scary place!!!

[Peikko 1,575]

Just put a stop to medicaid, who needs it? Not us rich folks.

[Pinocchio Liberal 268]

Why work? When you can get it for free!

[IAMX 3,055]

Fraud occurs everywhere, and obviously should be prosecuted fair and justly.

However, strange that the people so far mostly outraged about this weren't so outraged about the wasted 3+ trillion dollars on a bullshit war. Nor are they outraged at the wasted trillion+ given to Israel with nothing in return but being spied on for our generosity.

Guess that's why no one takes their opinion seriously on rational debates regarding health care.

[Pinocchio Liberal 268]

Fraud occurs everywhere, and obviously should be prosecuted fair and justly.

However, strange that the people so far mostly outraged about this weren't so outraged about the wasted 3+ trillion dollars on a bullshit war. Nor are they outraged at the wasted trillion+ given to Israel with nothing in return but being spied on for our generosity.

Guess that's why no one takes their opinion seriously on rational debates regarding health care.

NO PRGRAM, NO FRAUD!

[Empress of Groovy 373]

This article is about Medicare being defrauded, right? Not Medicare doing the defrauding?

[Pinocchio Liberal 268]

This article is about Medicare being defrauded, right? Not Medicare doing the defrauding?

Yeah thats it, lets split some short and curlies!

[IAMX 3,055]

Fraud occurs everywhere, and obviously should be prosecuted fair and justly.

However, strange that the people so far mostly outraged about this weren't so outraged about the wasted 3+ trillion dollars on a bullshit war. Nor are they outraged at the wasted trillion+ given to Israel with nothing in return but being spied on for our generosity.

Guess that's why no one takes their opinion seriously on rational debates regarding health care.

NO PRGRAM, NO FRAUD!

No government, no rules, no morals, no fraud.

There's something I can go for.

Otherwise, there's a compromise.

Edited October 7, 2008 by SRVT

[Empress of Groovy 373]

This article is about Medicare being defrauded, right? Not Medicare doing the defrauding?

Yeah thats it, lets split some short and curlies!

I think you may have misread the article.

Medicare fraud is a huge problem. I just finished editing a book about managed care (zzzz....). Actually, the most interesting chapter was on fraud.

Marc, if I may ask, are you planning to forgo Medicare when you're eligible?

[Pinocchio Liberal 268]

Fraud occurs everywhere, and obviously should be prosecuted fair and justly.

However, strange that the people so far mostly outraged about this weren't so outraged about the wasted 3+ trillion dollars on a bullshit war. Nor are they outraged at the wasted trillion+ given to Israel with nothing in return but being spied on for our generosity.

Guess that's why no one takes their opinion seriously on rational debates regarding health care.

NO PRGRAM, NO FRAUD!

No government, no rules, no morals, no fraud.

There's something I can go for.

Otherwise, there's a compromise.

Compromise is kinda like gettin shite on, then wipin it off and sayin it was an accident. Also known as, I didnt mean it!

This article is about Medicare being defrauded, right? Not Medicare doing the defrauding?

Yeah thats it, lets split some short and curlies!

I think you may have misread the article.

Medicare fraud is a huge problem. I just finished editing a book about managed care (zzzz....). Actually, the most interesting chapter was on fraud.

Marc, if I may ask, are you planning to forgo Medicare when you're eligible?

If its not there how could I be eligble, huh? The question is, why arent you payin for your poor neighbors healthcare?

[Empress of Groovy 373]

Fraud occurs everywhere, and obviously should be prosecuted fair and justly.

However, strange that the people so far mostly outraged about this weren't so outraged about the wasted 3+ trillion dollars on a bullshit war. Nor are they outraged at the wasted trillion+ given to Israel with nothing in return but being spied on for our generosity.

Guess that's why no one takes their opinion seriously on rational debates regarding health care.

NO PRGRAM, NO FRAUD!

No government, no rules, no morals, no fraud.

There's something I can go for.

Otherwise, there's a compromise.

Compromise is kinda like gettin shite on, then wipin it off and sayin it was an accident. Also known as, I didnt mean it!

This article is about Medicare being defrauded, right? Not Medicare doing the defrauding?

Yeah thats it, lets split some short and curlies!

I think you may have misread the article.

Medicare fraud is a huge problem. I just finished editing a book about managed care (zzzz....). Actually, the most interesting chapter was on fraud.

Marc, if I may ask, are you planning to forgo Medicare when you're eligible?

If its not there how could I be eligble, huh? The question is, why arent you payin for your poor neighbors healthcare?

I am paying for my poor (and indeed elderly) neighbors' health care. And care for everyone on my very expensive group plan who makes a claim. And a sh!tload toward my health insurance companies' exorbitant executive salaries, marketing, and administrative costs. All in the name of choice, of course.

Are you suggesting that Medicare should be abolished? Somehow I don't think that the magical private market could find a way to make money off sick old people on a fixed income. This was apparent even before health care got crazy expensive. Of course, when it was created, Medicare was established in a different economic era; for example, no pharmaceutical company was charging the equivalent of the country's average monthly wage for a course of pills, doctors weren't paying off $100K in medical school loans, and OB/GYNs weren't having to fork over tens of thousands in malpractice premiums. Medicare's biggest obstacle isn't the program itself but the private, profit-at-all-costs context in which it operates. Which is really screwing practically everyone.

[Pinocchio Liberal 268]

Fraud occurs everywhere, and obviously should be prosecuted fair and justly.

However, strange that the people so far mostly outraged about this weren't so outraged about the wasted 3+ trillion dollars on a bullshit war. Nor are they outraged at the wasted trillion+ given to Israel with nothing in return but being spied on for our generosity.

Guess that's why no one takes their opinion seriously on rational debates regarding health care.

NO PRGRAM, NO FRAUD!

No government, no rules, no morals, no fraud.

There's something I can go for.

Otherwise, there's a compromise.

Compromise is kinda like gettin shite on, then wipin it off and sayin it was an accident. Also known as, I didnt mean it!

This article is about Medicare being defrauded, right? Not Medicare doing the defrauding?

Yeah thats it, lets split some short and curlies!

I think you may have misread the article.

Medicare fraud is a huge problem. I just finished editing a book about managed care (zzzz....). Actually, the most interesting chapter was on fraud.

Marc, if I may ask, are you planning to forgo Medicare when you're eligible?

If its not there how could I be eligble, huh? The question is, why arent you payin for your poor neighbors healthcare?

I am paying for my poor (and indeed elderly) neighbors' health care. And care for everyone on my very expensive group plan who makes a claim. And a sh!tload toward my health insurance companies' exorbitant executive salaries, marketing, and administrative costs. All in the name of choice, of course.

Are you suggesting that Medicare should be abolished? Somehow I don't think that the magical private market could find a way to make money off sick old people on a fixed income. This was apparent even before health care got crazy expensive. Of course, when it was created, Medicare was established in a different economic era; for example, no pharmaceutical company was charging the equivalent of the country's average monthly wage for a course of pills, doctors weren't paying off $100K in medical school loans, and OB/GYNs weren't having to fork over tens of thousands in malpractice premiums. Medicare's biggest obstacle isn't the program itself but the private, profit-at-all-costs context in which it operates. Which is really screwing practically everyone.

I like your use of words implicating "sick old ppl" as the cause! Like somehow I want sick old ppl to pay! Your bleedin heart bullshite dont float at all. Same old game your playin with the "old"

Its about ppl that SUCK the system because they can! You commin off like the almighty caring, above the frey, I wanna spend other ppls money BS is so ridiculous.

Go hang out your breast of love and see how many toothy bastards rub you raw! My god man your nuts!

[Empress of Groovy 373]

Fraud occurs everywhere, and obviously should be prosecuted fair and justly.

However, strange that the people so far mostly outraged about this weren't so outraged about the wasted 3+ trillion dollars on a bullshit war. Nor are they outraged at the wasted trillion+ given to Israel with nothing in return but being spied on for our generosity.

Guess that's why no one takes their opinion seriously on rational debates regarding health care.

NO PRGRAM, NO FRAUD!

No government, no rules, no morals, no fraud.

There's something I can go for.

Otherwise, there's a compromise.

Compromise is kinda like gettin shite on, then wipin it off and sayin it was an accident. Also known as, I didnt mean it!

This article is about Medicare being defrauded, right? Not Medicare doing the defrauding?

Yeah thats it, lets split some short and curlies!

I think you may have misread the article.

Medicare fraud is a huge problem. I just finished editing a book about managed care (zzzz....). Actually, the most interesting chapter was on fraud.

Marc, if I may ask, are you planning to forgo Medicare when you're eligible?

If its not there how could I be eligble, huh? The question is, why arent you payin for your poor neighbors healthcare?

I am paying for my poor (and indeed elderly) neighbors' health care. And care for everyone on my very expensive group plan who makes a claim. And a sh!tload toward my health insurance companies' exorbitant executive salaries, marketing, and administrative costs. All in the name of choice, of course.

Are you suggesting that Medicare should be abolished? Somehow I don't think that the magical private market could find a way to make money off sick old people on a fixed income. This was apparent even before health care got crazy expensive. Of course, when it was created, Medicare was established in a different economic era; for example, no pharmaceutical company was charging the equivalent of the country's average monthly wage for a course of pills, doctors weren't paying off $100K in medical school loans, and OB/GYNs weren't having to fork over tens of thousands in malpractice premiums. Medicare's biggest obstacle isn't the program itself but the private, profit-at-all-costs context in which it operates. Which is really screwing practically everyone.

I like your use of words implicating "sick old ppl" as the cause! Like somehow I want sick old ppl to pay! Your bleedin heart bullshite dont float at all. Same old game your playin with the "old"

Its about ppl that SUCK the system because they can! You commin off like the almighty caring, above the frey, I wanna spend other ppls money BS is so ridiculous.

Go hang out your breast of love and see how many toothy bastards rub you raw! My god man your nuts!

Marc, this article is about agencies making massive fraudulent Medicare claims, not people receiving Medicare benefits fraudulently. In many cases, the entities sucking the system because they can are private, for-profit businesses (home health care agencies, for example). Your responses suggest that you're not clear on this.

My position is that if I'm going to be paying this much into various systems, I'd like to get more out of it than temporary coverage that will end as soon as my employment does.

I may have misunderstood your post, but I thought you were suggesting that Medicare shouldn't exist, as if a private entity could provide the same service if given the chance.

p.s. Breast of love?