Miami’s Real Vice: Medicare Fraud, to the Tune of $137 Million

Last Wednesday on May 2, a federal task force committed to cracking down on Medicare fraud charged 107 suspects with submitting more than $450 million worth of false Medicare reimbursement claims in seven cities across the U.S. More than half were from the Miami area, and four of the schemes involved home health agencies.

The takedown involved the highest amount of false Medicare billings in a single takedown in strike force history, according to the U.S. Department of Justice.

The Miami area, in particular, is well-acquainted with Medicare fraud, as 59 of the 107 suspects are from South Florida and are accused of trying to steal $137 million in falsely-claimed reimbursements.

“More than half of those charged in a record setting health care fraud takedown today were from the Miami area. The local fraud totaled more than $137 million. Sadly, in Miami, multi-million dollar health care fraud cases are no longer shocking in their magnitude or frequency,” said John V. Gillies, Special Agent in Charge of the FBI’s Miami Office, in a statement. “Here’s my message clear and simple, you can run, but as evidenced by today’s nationwide takedown, you can’t hide.”

“South Florida has the lion’s share of the cases,” agreed U.S. Attorney Wifredo Ferrer during a press conference following a Justice Department briefing on the fraud crackdown.

The 21 cases involve a variety of defendants ranging from clinic owners, nurses, therapists, former social workers, patient recruiters, and even beneficiaries, Ferrer said, adding that they “stole precious health care dollars through a variety of schemes… at the expense of the most vulnerable in our society.”

The healthcare fraud-related schemes include conspiracy to commit healthcare fraud; healthcare fraud; violations of anti-kickback statutes; and money laundering.

The charges are based on a variety of alleged fraud schemes involving various medical treatments and services such as home health care and physical and occupational therapy, says the Justice Department. Home health agencies identified as involved with fraudulent reimbursement claims include Super Star Home Health, based in Miami-Dade County; Ideal Home Health; Willsand Home Health, Inc.; and Ronat Home Health Care, Inc.

Medicare’s Fraud Strike Force is part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative between the Department of Justice and the Department of Health and Human Services that began in 2007. Since then, the Strike Force has charged more than 1,330 defendants who have collectively falsely billed Medicare for more than $4 billion.

Written by Alyssa Gerace

Alyssa Gerace



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