Today's Mafia: Medicare Fraud - Less Risk, More Reward

Why risk running gambling operations, loan sharking and labor racketeering when you can milk Medicare for $25,000 a day while risking a relatively modest 10 years in prison if convicted on a single count? 
Today two Miami clinic operators have been convicted in what investigators say was a $51 million HIV infusion fraud case. 
Times have changed.

Scarlet Duarte was convicted of conspiracy to launder money and money laundering, and Rechart Garcia was convicted of conspiracy to commit health care fraud, health care fraud, conspiracy to pay health care kickbacks, conspiracy to launder money and money laundering.

According to the evidence presented at trial, the fraud involved purported treatment of HIV-positive Medicare beneficiaries at five clinics in Miami-Dade County, and a sixth that operated in Collier and Lee counties.

GONE ARE THE GOODFELLAS DAYS
They are alleged to have paid Medicare beneficiaries to pretend to receive treatment at the clinics, and then billed Medicare for treatment that was never provided and would not have been medically necessary, according to a news release from the acting U.S. attorney for the Southern District of Florida.

In all, the clinics submitted approximately $51.8 million in fraudulent claims, of which Medicare paid them about $21.1 million.

More on the subject -- Mafia, violent criminals turn to Medicare fraud
By KELLI KENNEDY (AP) MIAMI — Lured by easier money and shorter prison sentences, Mafia figures and other violent criminals are increasingly moving into Medicare fraud and spilling blood over what was once a white-collar crime.

Around the nation, federal investigators have been threatened, an informant's body was found riddled with bullets, and a woman was discovered dead in a pharmacy under investigation, her throat slit with a piece of broken toilet seat.

For criminals, Medicare schemes offer a greater payoff and carry much shorter prison sentences than offenses such as drug trafficking or robbery.

"We've seen more people that used to be involved in (dealing) drugs are switching over to health care fraud because it's not as dangerous," Miami FBI spokeswoman Judy Orihuela said.

Medicare scammers typically make their money by billing Medicare for medical equipment and drugs that patients never receive — and never needed. Some pay homeless people on Los Angeles' Skid Row for Medicare or Social Security numbers to use in fake billing invoices. Others intimidate elderly victims to use their Medicare numbers, federal authorities say.

Most Medicare schemes are based in cities such as Miami, Los Angeles, Detroit and Houston. And rather than building an elaborate hierarchy like the Mafia or other gangs, many Medicare con artists use common street criminals to recruit patients and doctors, authorities said.

A Medicare scammer could easily net at least $25,000 a day while risking a relatively modest 10 years in prison if convicted on a single count. A cocaine dealer could take weeks to make that amount while risking up to life in prison.

"Building a Medicare fraud scam is far safer than dealing in crack or dealing in stolen cars, and it's far more lucrative," said Lewis Morris, lead attorney at the Department of Health and Human Services' inspector general's office.

It's unclear how many violent crimes are tied to Medicare fraud because most of them are carried out by someone within the hoax who attacks another person taking part in the crime.

One Southern California criminal task force has arrested about 50 suspects for Medicare fraud in the last three years.

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SOURCE: http://www.google.com/hostednews/ap/article/ALeqM5gkMiV-gKQhCN626RwnoxQKm8eM7AD9B5Q4280