Florida re­gains cham­pi­onship!

Modern Healthcare - - Outliers -

And speak­ing of Florida … the ti­tle for Biggest Medi­care Fraud in U.S. His­tory went ping-pong­ing across the coun­try last month, as Cal­i­for­nia briefly stole the award from long-reign­ing cham­pion South Florida with an or­ga­nized crime nar­ra­tive fit for a James Ell­roy novel.

But the up­start Golden State held the cov­eted place in Medi­care his­tory for nary a fort­night be­fore South Florida again re­claimed the crown with a tale fea­tur­ing lux­ury cars, trips to Switzer­land and Medi­care-code swap­ping par­ties wor­thy of a Carl Hiassen plot.

South Florida has, for what­ever rea­son, long been the site of the largest busts for Medi­care fraud by crim­i­nal or­ga­ni­za­tions, per­haps be­cause of the damn fine po­lice work of Mi­ami’s Medi­care Fraud Strike Force, which as re­cently as July co­or­di­nated the charg­ing of 94 peo­ple na­tion­ally in billing fraud schemes.

Then out of nowhere comes Op­er­a­tion Di­ag­no­sis Dol­lars, which re­sulted in charges against 73 peo­ple in an al­leged $163 mil­lion fraud, plus the pros­e­cu­tion of a group that au­thor­i­ties de­scribed as an Ar­me­nian “or­ga­nized crime en­ter­prise” based in the Los An­ge­les sub­urb of Glen­dale—the first crime out­fit from part of the for­mer Soviet Union charged with rack­e­teer­ing in the U.S. since 1996.

The Oct. 13 bust was im­me­di­ately called “the largest Medi­care fraud scheme ever per­pe­trated by a sin­gle crim­i­nal en­ter­prise” by pros­e­cu­tors, ac­cord­ing to the LA Times.

Not con­tent to sit on the side­lines, how­ever, Mi­ami’s strike force on Oct. 21 an­nounced its own biggest case ever—to­tal­ing $200 mil­lion, per­pe­trated by four ex­ec­u­tives at what it said was the nation’s largest chain of com­mu­nity mental health cen­ters, Amer­i­can Ther­a­peu­tic Corp.

“The scope of the al­leged Medi­care fraud sur­passed that of a vast net­work of Ar­me­nian gang­sters and their as­so­ci­ates charged last week op­er­at­ing phan­tom health­care clin­ics to try to cheat the fed­eral pro­gram out of $163 mil­lion,” the Mi­ami Her­ald help­fully clar­i­fied in its ini­tial story on the bust.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.