HIV and Medicare Fraud a Costly Combination
Medicare is an essential program that was designed to help the elderly and the vulnerable. Presently, Medicare covers over 44 million people so that they can receive medical care.
Fraud has long been an issue regarding Medicare. There have been too many loopholes, a system that is designed in a manner that makes fraud easy, and too little oversight of the billions of budget dollars intended for legitimate Medicare expenses.
In addition, there have been – and still are – unscrupulous business people out there who have designed ways to defraud the Medicare system. It is one thing to make a mistake, it is quite another to intentionally set up a business network for the express purpose of taking money from the most vulnerable of our citizens, especially when that money is scarce to begin with.
The latest in a series of fraud-based businesses to take advantage of the lax oversight over Medicare dollars is a scheme involving HIV/AIDS clinics in south and mid-Florida. These clinics have made so much money that officials are asking the public for help in stopping the fraud.
Officials have announced a new “Infusion Fraud” hotline, asking the public to call and report phony HIV/AIDS treatment in an effort to stop clinic operators from receiving millions for services and treatments not provided. These unscrupulous clinic operators have been most prevalent in south Florida and purchase Medicare lists or pay patients to come into their offices, and then bill Medicare for millions of dollars in fraudulent claims for treatments never provided. Last week a couple who ran a billing service was sentenced to 14 years in prison for billing nearly $150 million in fraudulent claims for 85 different clinics.
There are several ways that Medicare is trying to combat fraud in that area. They have set up a hotline that people can call to report fraud if they become aware of it. The fraud does not have to be HIV/AIDS related; it can involve any fraudulent issues or scams with Medicare.
Medicare is also sending out Medicare statements to recipients in southern Florida on a monthly basis instead of quarterly in hopes that people will look at their statements and report any treatments or charges listed that were not received or don’t look legitimate. By doing this monthly instead of quarterly, there is less of a time lag, giving Medicare a better chance of catching the perpetrators while they are still up and running and in business.
Records show that last year HIV/AIDS claims for treatment totaled $1.5 billion in south Florida as compared to only $300 million in New York City. This is an obvious imbalance that is receiving attention.
The phone number to report suspected Medicare fraud is 866-417-2078.
