Foreign Medicare Fraud

Wall Street Journal ^ | 6/19/2012 | By MARY ANASTASIA O'GRADY

[Eva]

The $31 million Medicare-fraud case reported from Miami yesterday may not be the largest in American history but certainly is one of the more innovative. According to the Miami Herald, it is "the first such case that directly traces money fleeced from the beleaguered program into the Cuban banking system." The Herald described the heist as "an intricate system" that funneled money "from fraudulent HIV treatment and medical equipment billings, first through banks in Canada and Trinidad and eventually [to] Cuba."

[Eva]

This is certainly not the first case of foreigners looting the medicare system.

Here is a link to an article about the Russian Mafia in LA

Alleged Medicare Fraud Busted in LA

This is a link to an article that appears to be the start of the investigation. The new wrinkle in the WSJ article is that the Castro brothers seem to be taking a cut of the illegal proceeds.

Physician Sentenced to 20 years for Medicare Fraud

[spankalib]

It’s the ethnic gang; Nigerians, Chinese, Russians, Norks - name more for great prizes! -

whose very language is their security.

Open a front in a strip mall.
When the heat gets turned up (usually takes the incompetent feds @ a year or two to notice unusual billing patterns)-
woosh!
Off they go in the middle of the night.

Miami. Houston. Dallas. LA. Chicago.
All cities provide anonymity for these thieves.

The true amount of fraud is purposefully hidden by the feds.
Ain’t that a kick?

[Eva]

Private insurance companies hire people to audit insurance claims from hospitals and clinics, looking for patterns. Why doesn’t the government?

[Cyman]

“Why doesn’t the government?”

They do. It is called the RAC(Recovery Audit Contractors). They get paid a percentage of whatever fraud they find or think they find.

Recent reports show that these Nazi’s collect less money than they are paid.

[ken in texas]

Some years back didn't IBM offer some supercomputer resources to the government at no charge to help spot fraudulent patterns in claims?

As I recall the Feds said something like "thanks, but we don't need it".