Recent Medicare Fraud Scams and Busts

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Recent Medicare Fraud Arrests Medicare fraud is one of the biggest sources of waste in America’s healthcare industry. Billions of dollars are lost each year, usually as a result of healthcare providers billing the government for services that aren’t medically necessary or weren’t even provided. But recently, the government has taken action in order to put the brakes on this type of fraudulent behavior.

A major crackdown took place across the country, which resulted in 89 individuals, of which 14 were licensed doctors and nurses, being charged for the role they played in Medicare frauds which cost taxpayers over $233 million.

Among the people recently arrested in connection with the crackdown, some have posed as medical doctors and wrote false prescriptions for therapies and medications, then billed the Medicare system for $12 million.

Another common scam involved fraud artists giving bribes to individuals on Medicare so they can use their ID numbers to bill the government for healthcare services that were completely unneeded and in many cases were never provided. It is estimated that the government lost $20 million to this type of scam.

Not surprisingly, the main motivation for those behind these schemes was money. Many of the suspects in the case lived in upscale neighborhoods. The main suspect, who has allegedly swindled millions of dollars from the government, used some of the fraudulent proceeds to buy luxury vehicles, such as a Ferrari and two Lamborghini’s.

With recent budget cuts affecting Medicare payments, the recent crackdown is definitely welcome news for the nation. The less money is wasted due to fraudulent claims, the more money remains so that people who have to rely on Medicare get the high quality and accessible healthcare that they rightfully deserve.

The size of the recent crackdown and the dollar figures involve all reinforce the notion that Medicare fraud is big. There are also worries that for every criminal that gets apprehended for defrauding the Medicare system, there are dozens of others who continue to fly below the radar, bilking millions of dollars out of the system without anybody noticing.

The arrest of Roberto F. Marrero, an actor living in Miami, and his wife Sandra Fernandez Viera in connection with the fraud crackdown should lead to serious questions about the fraud prevention measures the government undertakes. Neither Marrero nor his wife were licensed to practice medicine in any state. But they still managed to submit $20 million in fraudulent claims to the government. If the government can’t even verify whether someone submitting claims is a legitimate medical practitioner, then it needs to make serious improvements to its Medicare fraud prevention system.

If you or anyone you know would like to report Medicare fraud in your area, visit StopMedicareFraud.gov.

What do you think the government should do to stop Medicare fraud before it happens? Let us know in the comments below.

About the author

Hank Pomeranz

Hank Pomeranz is the co-owner of Medicarebenefits.com and has been writing about Medicare since 1998. Follow us on Twitter @medicareblog

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    Indeed, Medicare scams are among the common kinds of fraud especially that people usually jump on it because it is health related. Thank you for sharing this post. I know for sure that this information will greatly help others avoid become victim of such scams.