To help pay for reforms, Medicare fraud ripe for plucking, top South Florida prosecutors say

MIAMI — Democratic party leaders have pledged to pay for the new $940 billion health care reform law, in large part, by eliminating $500 billion in waste and fraud in Medicare over the next decade.

Miami will almost certainly be their first stop.

According to federal investigators:

-- In 2008, of all the Medicare payouts for home health care services nationwide, over 50 percent were shelled out in Miami-Dade. That was despite the fact that only 2 percent of patients receiving such federally-funded care in the U.S. live in the county. Much of the billing was fraudulent.

-- Some persons listed as recipients of "home" health care services turned out be homeless people, who simply loaned their names to crooks.

-- When investigators went looking for firms that had been paid by Medicare for medical equipment, such as wheelchairs, walkers and hospital beds to be used in homes, they found that 30 percent of the companies didn't exist.

-- Much of the Medicare money was paid to companies that claimed they administered insulin shots to blind diabetics. But many of the patients weren't blind. In fact, many didn't have diabetes.

The investigators concluded that a growing chunk of Miami-Dade's gross domestic product is generated by Medicare fraud.

In 2008, suspects accused of $793 million in false Medicare claims were indicted in South Florida, about 90 percent in Miami-Dade. Last year that figure rose to $952 million.

Broward accounts for almost all the rest of the false billing and bilking.

In Palm Beach County such crimes are rare. Prosecutors say they have so much to do busting big time Medicare "fraudsters" in Miami that they haven't had time for the small schemes that might exist farther north.

"The big numbers are in Miami-Dade," says U.S. Attorney for the Southern District of Florida Jeffrey Sloman. "And the methods of Medicare fraud that you see around the country, their evolution started here in South Florida."

Critics argue that trimming Medicare by $500 billion is unrealistic and benefits will suffer if that amount is cut. But Sloman does not find the figure farfetched.

"I can't see why not," he says about saving hundreds of billions of dollars.

"Between enforcement, new legislation and regulation, I think that can be done."

Sloman was appointed by the Obama administration. But his view is shared by his predecessor, R. Alexander Acosta, who was named by Republican President W. Bush and who instituted a special Medicare fraud "strike force" in South Florida in 2006 -- the first in the nation.

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