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Miami Medicare Fraud Ring Cracked, 39
Held - U.S.
04:45 p.m Oct 21, 1998 Eastern
By Jim Loney
MIAMI (Reuters) - Federal agents dismantled a
massive Medicare fraud ring in which doctors, nurses
and patients conspired to bilk U.S. taxpayers of $10
million with fake home health-care claims, prosecutors
said Wednesday.
The Miami U.S. Attorney's Office unsealed three
indictments charging 39 people, including seven
doctors and 12 nurses, with fraud against Medicare by
submitting bogus claims for services for homebound
Medicare beneficiaries.
They said the sophisticated ring, which operated in the
Miami area, was part of a $3 billion health-care fraud
problem in southern Florida, home to thousands of the
elderly and a vast array of financial scams.
''It's a fraud against our parents and our grandparents,
taking money away from health care for those people,''
said Al Hallmark, regional inspector general for the
Department of Health and Human Services. ''They're
stealing the money just as if they were doing it with a
gun.''
The indictments, the result of a three-year undercover
investigation by the FBI, the Internal Revenue Service
and other U.S. agencies, said the scam used
Miami-based Amitan Health Services, a
Medicare-certified home health agency, to funnel
fraudulent claims to the U.S. health program for the
elderly.
Amitan's owners, Ramon Dominguez and Rene
Corvo, worked with a ring of doctors and nurses to
overbill for services provided to Medicare
beneficiaries or to submit fake bills for home health
services that were never provided, prosecutors said.
Amitan and its subcontractors controlled pools of
Medicare patients, most of whom did not qualify for
home health services, prosecutors said.
''In some instances, the nurses would simply, literally,
clean up the patient's room and then Medicare would
be billed for skilled nursing visits,'' Miami U.S.
Attorney Thomas Scott said.
Kickbacks were paid to people who recruited
Medicare patients for Amitan, the indictment alleges.
Prosecutors said Amitan had a group of employees
fabricating medical records and claim forms and
doctors and nurses signing the forms or allowing their
names to be used. The fraud resulted in at least $10
million in Medicare losses, they said.
The FBI cracked the ring by buying and operating a
small home health agency called Perfect Nursing,
which solicited business and funneled it through
Amitan.
Dominguez and Corvo were among the 39 people
indicted. They face charges of conspiracy and fraud.
Scott said the ring was part of a nationwide Medicare
fraud problem that raised health-care costs for every
American, and he criticized patients who failed to
report fraud.
''Some of the estimates we have estimate that as high
as 40 percent, four out of every ten dollars, is fraud,
cheating,'' he said. ''The patients are an integral part of
the scheme, which wouldn't work without them.''
Copyright 1998 Reuters Limited. |
