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Health care fraud common in Florida and across the country

Nov 6, 2017 | Fraud

Thanks to a large population, including a high number of aging and retired residents, Florida sees a higher than average amount of fraud cases. In fact, as recently as 2015, Florida had the highest rate of fraud risk among all fifty states. Those figures deal with identity theft and similar kinds of interpersonal fraud, but Florida has seen much more organized and complex forms of fraud as well.

Florida also sees a substantial amount of health care fraud. Although many people imagine health care fraud as people getting Medicaid or Medicare benefits they don’t deserve, the biggest losses are associated with medical professionals, billing specialists or similar people committing acts of fraud. Florida has been home to some of the biggest health care fraud cases in recent memory.

Recent fraud arrest highlight white collar health care fraud issues

White collar crimes can end up costing the state and taxpayers millions, or, in this case, over a billion. Early in the summer of 2017, three Florida residents got arrested as a result of a national investigation regarding health care fraud. According to the United States Justice Department, the fraud and money laundering scheme involving the arrested parties made more than $1 billion between 2009 and 2017.

The three people arrested had varying levels of authority. One was the person who owned more than 30 skilled nursing and assisted living facilities around Miami, another was a hospital administrator, while the third was a physician’s assistant. All three face criminal charges including conspiracy, money laundering and health care fraud. Documents from the courts indicate that the three ordered and billed for unnecessary treatments and tests, as well as intentionally providing narcotics to patients and elders with addiction issues.

Health care fraud by providers is costly and too common

Although much of the public discussion about health care fraud focuses on issues involving individual patients, fraud by providers can end up costing much more in the long run. Although administrators are often the ones responsible, this recent Florida case shows how people of varying positions and degrees of authority can end up involved in a white collar crime involving health care fraud. People who work in health care could end up facing charges even if they weren’t directly involved in ordering unnecessary treatments or engaged in any fraudulent billing.

All you need to do to end up facing consequences is to ignore information that shows a crime. When it comes to fraud cases, a number of people may see things that seem suspicious without doing anything. Those individuals could end up facing accessory charges or worse. Anyone from billing clerks, who could overbill or change billing codes, to scheduling professionals, who could suggest a particular specialist in the hope of a kickback, could engage in health care fraud.


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