Patient Participation in Some Medicare Fraud Schemes
In a recent Associated Press article, Kelli Kennedy explores the role that some Medicare beneficiaries have played in the Medicare infusion therapy fraud schemes arising out of Southern Florida.
As reflected in the article, at least one Medicare beneficiary made $100 to $200 per visit and collected about $10,000 over several months selling his Medicare number to 3 Florida clinic owners that were later indicted for allegedly bilking $119 million from the Medicare program. The article also suggests that Federal authorities believe that there may be thousands of patients in Southern Florida (and other parts of the country) actively involved in various Medicare fraud schemes, including schemes that involve non-rendered and medically unnecessary services.
Since May 2007, a Medicare Fraud Strike Force has yielded a stream of arrests and indictments of health care providers and suppliers operating in Southern Florida. However, the article reveals that Federal prosecutors may be divided on whether the patients actively participating in the Medicare fraud schemes should be an enforcement priority.
Apparently, some prosecutors believe that prosecuting the patients could serve as a deterrent. However, other prosecutors believe that it is more effective to focus time and resources on pursuing the Medicare providers and suppliers involved in Medicare fraud schemes. In fact, the article suggests that some prosecutors may be reluctant to prosecute the patients involved in Medicare fraud schemes because "juries are often sympathetic to elderly and terminally ill defendants, even if they are guilty."
The question now is should the patients participating in Medicare fraud schemes with Medicare providers and / or suppliers be an enforcement priority for the Department of Justice?
Reprinted from Medicare Update under Creative Commons.