Tuesday, June 27, 2006
Carmel on the Case: Medicare
South Florida has the dubious distinction of being a hotbed of health care fraud. But now - for the first time - federal authorities are concentrating on smaller con artists who by stealing less used to attract less attention. Investigative reporter Carmel Cafiero is On The Case.
WSVN--If you're poor or disabled or elderly - getting sick in this country can be very expensive.
The bill for Medicare or Medicaid - about half a trillion dollars a year.
But now experts estimate one tenth of those charges are fraudulent.
Alvyn Meyer: "I've never had a broken bone, much less part of them replaced."
Seventy-one year old Alvyn Meyer got a first hand look at health care fraud. When he started getting copies of bogus bills in the the mail.
Alvyn noticed doctors he never saw and never knew were charging medicare for medical devices he never needed or received.
Alvyn Meyer: "One could have been a mistake. When I got the second one - I was starting to get suspicious and when the third and fourth one come I really wonder who's trying to run some sort of scam."
The charges total more than nine thousand dollars.
Alvyn was so concerned, he reported the fraud to the federal authorities.
Alex Acosta: "We need to make it clear this can't continue."
Alex Acosta is the U.S. attorney.
Traditionally big time federal cases can take years to investigate.
But now Acosta says a team has been created to concentrate on smaller scams ones that involve frauds of five million dollars or less.
Alex Acosta: "They're not gonna fly underneath the federal radar. And so this quick hit squad is focused on the quick smaller cases."
Like these orthopedic devices.
The government was billed two million dollars by the manufacturer even though nobody ever requested them.
The evidence is stored in a South Florida facility that is unlike any other in the country.
Alex Acosta: "Over in that room is our active case file. We have over a hundred active cases."
Acosta couldn't show us much for obvious reasons - but this building puts agents investigating health care under one roof.
They even have a nurse practitioner to help determine what are legitimate medical ailments and equipment.
Alex Acosta: "She understands health care and she knows what is appropriate and what isn't. And this is a case where a health care practitioner can work with agents."
When it comes to what is not appropriate - consider this one point eight million dollar chair.
A scammer took pictures of patient after patient sitting in this motorized wheelchair.
Then he billed medicare thousands of dollars claiming each person got a chair.
But in the end - he got prison.
Alex Acosta: "And the sad this is not a single patient needed the wheelchair. They could all walk."
Carmel Cafiero: "Also sad - the fact that all too often people who legitimately need medical care - sometimes can't get it. Authorities say if you get a bogus bill don't just ignore it - report it. Every dollar saved is a dollar that can go to those who need it. Carmel Cafiero 7 News."
If You Have A Story For Carmel:
Call her in Dade at 305-627-CLUE
Or in Broward at 954-921-CLUE