Health care fraud no longer a faceless crime

Scams cost taxpayers $60 billion a year, but bank holdups get more attention




WASHINGTON — Health care fraud used to be a faceless crime — until now.

Medicare and Medicaid scams cost taxpayers more than $60 billion a year, but the average bank holdup is likely to get more attention. Seeking the public's help to catch more than 170 fugitive fraudsters, the government has launched a new health care most-wanted list, with its own website.

Among those featured is Leonard Nwafor, convicted a couple of years ago in Los Angeles of billing Medicare more than $1 million for motorized wheelchairs that beneficiaries didn't need. One of those who got a wheelchair was a blind man who later testified he couldn't see to operate it.

Facing time in federal prison, Nwafor disappeared before his sentencing.

"We're looking for new ways to press the issue of catching fugitives," said Gerald Roy, deputy inspector general for investigations at the Health and Human Services Department. "If someone walks into a bank and steals $3,000 or $4,000, it would be all over the newspaper. These people manage to do it from a less high profile position, but they still have a tremendous impact."

Even though motorized wheelchairs can run from under $1,000 to $7,000 apiece, Nawfor's scam was on the low end when compared to others who made the most-wanted list.

Sisters Clara and Caridad Guilarte allegedly submitted $9 million to Medicare in false and fraudulent claims for pricey infusion drugs that were never provided to patients. They are accused of offering cash and other rewards for beneficiaries to visit their clinic in Dearborn, Mich., and sign forms that said they received services that they never got.

An alleged accomplice was arrested in the Dominican Republic recently, but the sisters remain at large.

Scammers "often utilize their ties to a particular community," said Roy. "They take advantage of ethnic communities based on language barriers or lack of knowledge about how the Medicare system works. These folks are exploiting low-income communities."

Another fugitive, Susan Bendigo, is accused of billing California's Medicaid program for $17 million in nursing care, much of which was performed by staffers who weren't licensed. A registered nurse herself, Bendigo was the nursing director for a company that provided personnel for home health agencies. Allegedly, she was fully aware that she was required to send licensed nurses to care for patients.

Topping the list are Miami brothers Carlos, Luis and Jose Benitez. Owners of a string of medical clinics, they allegedly scammed Medicare out of $119 million by billing for costly HIV drugs that patients never received or did not need. Authorities say they bought hotels, helicopters and boats before fleeing to Cuba.

The FBI has the marquee most-wanted list, but the Environmental Protection Agency and other federal agencies also maintain their own. Roy said he hopes this newest list will raise awareness about the importance of combatting health care fraud. Medicare and Medicaid, which provide care for about 100 million Americans, are in serious financial trouble and can't afford to be hemorrhaging tens of billions a year because of fraud.

Most fraudsters go to elaborate lengths to avoid being detected. But there is often some telltale sign.

To document his transactions, wheelchair purveyor Nwafor assembled elaborate paper files, complete with bogus prescriptions and photos of beneficiaries in their wheelchairs. But investigators had a hunch they were on to something when they discovered that most of his customers lived nearly 200 miles away from his Los Angeles-area store front.

http://www.msnbc.msn.com/id/41438362/ns/politics/

But health care fraud can be a really good deal. Florida chose a poster boy for health care fraud to be their Governor.

OMG...

First is posted something important...

then someone comes along and ruins it with a bit of nasty propaganda...

Fanta the idea is good...

How much will it cost vs how much it actually recovers?

People don't want fraud... They should quit buying into 'easy' money.

Is it necessary for another expansion of Government to put a stop to it...

thought that was what the FBI was for.

Why "propaganda"? What's wrong with what I said?

Yes, I know!

Hey i got an idea let's nationalize healthcare so fruad goes from 60 billion a year to 600 billion a year! LMFAO! How ironic a dem is touting the point of veiw of an argument made by a republican on the floor of the senate! This is not news it was an exact point of conservatives against nationalized healthcare! Do you realize they even budget in fraud? fighting fruad in government by government?? huh? They don't even dispute fraud is rapant yet their idea is to increase the scope for more fraud? What idiots democrat politicians are!

In hussein terms, let's make it 60 Trillion. Boi does like to waste big.

Here's an example of how he saves taxpayers money and creates jobs.

thanx, stealing other peoples needed benefits is terrible
I hope they stay on top of it so the funds can be more likely to go to those who really are in need

They still can't seem to find those pesky Illegals.

Perhaps, they'll run across a few of 'em and some politicians while they are looking for folks pulling fraud scams.

Be our luck, they'll give the Illegals amnesty and the Citizen hard time.

people will always rank the different ways that others try to 'just make a better life for their kids'


if you steal from the bank to do it, people want justice
if you rob an individual straight on, people want justice
if you TRESPASS into a country, people say,,,'oh well'

The immigration problem could be solved easily and fairly costlessly. Just throw some illegal employers in jail. Neither side is willing to do it. The people in power on both sides want the illegals here, each for their own reasons. The result is a stupid expensive fence and the bigotry and harrassment in Arizona.

I'm not sure what the immigration problem has to do with Health Care fraud. Rick Scott isn't an illegal alien.

UH, DUH!!??
Illegals with stolen SSNs apply for SSI and SSD, no?

So, Az. enforcing a Constitutional Law that Hussein is refusing to do is discrimination and harassment.

Yes, the paid for politicians aren't doing their jobs and insisting on workplace investigations and raids.

Since Hussein has been in power, there has been one raid. That was one of Tyson Foods smaller processing plants.

I bet, the same Illegals rounded up are still working there.

IMO, Dr.s are the ones most likely committing the largest percentage of the fraud.

The only place I've heard about this is from some of the extreme right-wing sources. I didn't find any credible documentation of the problem. Did it make it into the news? Is this wide-spread? How much money have these illegals cost the health care system? Has this been going on for a long time, or is it a fairly recent phenomenon?

You are correct that the Federal Government is not, and never has enforced immigration law. Reagan, Bush, Clinton, Bush Obama. None of them have done it. The problem, of course, is that Arizona has no right to enforce Federal law. That leaves them with Jan Brewer, an un-electe Governor who got to be a right-wing hero with her "Please show me your papers" law. I do consider that to be harrassment. Add to that the School Superintendent moving a bill to prevent ethnic studies of any kind in the public schools.In a predominantly white populatio, I do consider that mildly bigoted.

The info is out there.
I guess, if MSNBC or any other State run media don't report it, it doesn't exist.

Speaking for Extremist Progressive Liberals .>>>

Not a very helpful response. Out there . . . where? There? Here? Someplace in-between? Over on top? Underneath someplace?

(BTW, I don't get MSNBC. Is that a left-wing version of Faux News)?

No!
They're America owned and fair!

Why do you always try to change the subject and venture far from the topic at hand?

Back away from the Kool Aide??
Does MSNBC and fair sounds like

Once again...

Why did we need a NEW law to handle this problem... With new FEDERAL EMPLOYEES and NEW regulations...

WE HAVE THE FBI... Is this not in their circle of influence?

It's not a bad point. Personally, I don't care how big Government gets as long as it makes life better for its citizens.I don't worry about the money, either. That is because every dollar that goes through the Government is destined to become somebody's income. It should be properly targeted. For example, The Bush/Paulson Bank bailout was really a jobs program for bank executives. The Obama/Geithner loan to GM was a jobs program for middle class working people.