Miami: Dozens Busted in Medicare Drug Fraud Scheme

According to one article on the latest fraud bust involving Medicare, Florida is number one in the nation for such schemes.

And, every time I see a story like this I imagine the massive fraud we would have if Elizabeth Warren got her dream program—Medicare for all!

Some of the names of those ‘new Americans’ arrested include: Ingrid Perdomo, Stirlitz Pio Diaz, Luiba Rodriguez Leyva, Diana Cabrera, Katia Ramirez, Daymis Sanchez, and Yanelys Lozano.  Cubans I’m guessing.

New American Economy?

When you hear from groups like Michael Bloomberg’s New American Economy about the entrepreneurial spirit and economic benefits ‘new Americans’ contribute to our country think about this bunch!  And, don’t forget, Bloomberg is a leading advocate for more immigration!

 

There are actually two separate busts…

Here is the first story from Tuesday that explains how the scam works from NBC Miami:

Nearly 20 Suspects Charged in Multi-Million Dollar Medicare Fraud Across 2 Miami Pharmacies

Nearly two dozen people have been charged by Florida’s Office of Statewide Prosecution for their involvement in a multi-million dollar Medicare fraud scheme that took place at two Miami pharmacies over the course of several years.

A total of 19 suspects are facing charges including organized fraud, racketeering, grand theft and money laundering, according to arrest warrants released Tuesday.

The scheme made use of professional beneficiaries, which are people who allow their Medicare benefits to be exploited by fraudsters in exchange for monetary compensation, the warrants said.

In this case, the professional beneficiaries involved were receiving up to 30 percent of the profits from each medication that was fraudulently billed by either Santander Pharmacy or Wynwood Family Pharmacy Corporation, the warrants said.

The beneficiaries would visit doctors in order to acquire prescriptions for medications they did not need. The prescriptions would be taken to Santander or Wynwood pharmacies, where the drugs would be charged to Medicare even though the drugs would never actually be dispensed or received.

The drugs that were fraudulently billed tended to be highly expensive, such as anti-psychotic drugs, according to the arrest warrants.

Since the operation began in Santander Pharmacy in 2015, more than $4 million in federal funds has been stolen using this method.

According to the arrest warrants, South Florida leads the country in this kind of Medicare fraud, particularly Miami-Dade and Broward counties.

Individuals establish a pharmacy by submitting corporate documents and obtaining a pharmacy license from the Florida Department of Health, and then commit fraud by submitting claims to Medicare for services that are never actually rendered or needed.

More here.

From the Miami Herald yesterday:

At least 30 people have been charged in connection with a string of South Florida pharmacies state authorities say fraudulently billed Medicare — a scam that continues to be one of Miami’s most lucrative illegal industries.

Police officers on Tuesday began arresting dozens associated with Tata Pharmacy Discount, Lozano Health Care, and in a separate case, Wynwood Family Pharmacy and Santander Pharmacy.

Those arrested in the sprawling case are facing charges of racketeering, organized scheme to defraud and money laundering.

The investigation was spearheaded by the Statewide Prosecutor’s Office, Miami-Dade police and U.S. Department of Health and Human Services.

Medicare fraud has long been rampant in South Florida, costing taxpayers billions. Over the past decade, pharmacies have become particular cash cows, with owners and middlemen scouring nursing homes, paying kickbacks to elderly patients in exchange for allowing them to bill for unnecessary medicines in their names.

Continue reading here.

I have more Medicare/Medicaid/Food Stamp fraud cases in my queue to post which I hope to get to in the coming days.