A recent article in the Tampa Bay Times recounts the cracking of a fraud case involving a Key Biscayne doctor, a kidney specialist, whose frequency of Medicare Part D prescriptions dramatically increased between 2010 and 2011, and then again between 2011 and 2012. The scam reportedly unraveled last September after a fanny pack of prescriptions signed by the doctor was given to authorities.
Federal officials say that the doctor scammed the government out of $7 million. Authorities have charged the doctor with 11 criminal counts, including aggravated identity theft, conspiracy, and fraud. A secretary the doctor’s clinic has also been charged and pleaded guilty to two counts of identity theft and conspiracy. She admitted to using paper prescription to fabricate fake scripts for reimbursement purposes. Another secretary has also pleaded guilty to similar charges.
Medicare fraud is not only an issue in Florida, though. It is a problem in various metropolitan areas. A recent USA Today article points out the problem of Medicare fraud in New York City. One particular problem in Brooklyn, say experts on the issue, is cross-referring patients for financial gain.
There is no doubt that Medicare and Medicaid fraud is a problem that needs to be addressed by federal law enforcement agencies. When health care providers cheat these programs, they are cheating the public. That being said, every provider accused of involvement in Medicare fraud has the right to defend himself or herself in court. In some cases, the charges may be completely unfounded. In other cases, the charges may simply be inappropriate or unsupported by the evidence. Whatever the case may be, it is important for those accused of fraud to work with a skilled attorney in building a strong case.
Source: Tampa Bay Times, “Fanny-pack mixup unravels South Florida Medicare drug fraud,” Charles Ornstein, July 11, 2014.USA Today, “Staggering pain claims in Brooklyn stoke suspicion,” Jayne O’Donnell & Megan Hoyer, July 9, 2014.