DME fraud is a ‘growth industry’ in south Florida

Friday, October 31, 2003

MIAMI - Healthcare fraud in south Florida is the worst in the nation, charged a duo of federal law enforcement officials who compared the problem in the Sunshine State to the wild west.

The U.S. Attorney’s Office of the Southern District of Florida’s Chief of Economic Crimes Section Angel Cortinas and U.S. Attorney David Frank made the comments as part of a September interview in the Miami Herald.

The investigators told the Herald that durable medical equipment fraud is going through the roof and inappropriate billing of Medicare for these items is a growth business in Miami.

With thousands of small DME providers servicing a large geriatric community in and around Miami, the area always has been a hot bed of fraud, said Everett Wilson, a healthcare attorney in Coral Gables, Fla.

“Medicare can’t audit all of them,” Wilson said. “It’s relatively easy to go along without being audited as long as you don’t bill a huge amount.”

While the fraud in south Florida spans provider groups, some of the schemes might involve phony wheelchairs being billed for people who do not need them. Another popular swindle is billing for prostheses that aren’t necessary, the investigators said. HME

Frank and Cortinas noted that many times elderly people were part of the fraud and they were willing recipients of a bribe or kickback money from fraudulent billings. They said the most disturbing aspect of this fraud in south Florida is that residents many times think, “A kick back is not such a big deal in the community.”

They also said the abuse was “not confined to any ethnic group” and it “is all over” the region because “where there is money” someone will try to commit fraud and it can involve “Hispanic, Anglo or Black people.