With all the fraud constantly being exposed, it’s no wonder our national debt keeps increasing at an alarming rate — politicians overspend, and fraudsters suck up billions more.
Our taxpayer-funded programs seem extremely vulnerable to fraud, including Medicare and Medicaid. Five ophthalmology practices in Florida have agreed to a $6 million settlement with the federal government over their fraudulent billing through a third-party for transcranial doppler ultrasounds (TCDs), according to the Department of Justice (DOJ). “These settlements are a continuing testament to the United States’ commitment to fight healthcare fraud and ensure that federal healthcare dollars are spent consistently with the law,” said U.S. Attorney Gregory W. Kehoe for the Middle District of Florida.
Florida Eye Institute P.A., Clay Eye Holdings LLC, Miami Eye LLC, Retina Macula Specialist of Miami LLC, and Kendall Eye Institute Inc. had a kickback arrangement with a testing company to accomplish their scheme between 2018 and 2022. They violated multiple laws and defrauded Medicare and Medicaid in the meantime. The whistleblower who filed against them under the False Claims Act is set to receive about $1.14 million of the settlement money.
“Kickbacks and false claims increase healthcare costs for all Americans and undermine the integrity of healthcare decision-making,” said Assistant Attorney General Brett A. Shumate of the Justice Department’s Civil Division. “Combatting such schemes will continue to be a priority for the Justice Department.”
Related: Maryland’s $760 Million Overpaid Unemployment Fraud Problem
Florida and the federal government coordinated in achieving the settlement agreement for the case. The DOJ announced that it is specifically targeting healthcare fraud and encouraged tips from anyone who believes he knows about any.
“Submitting false claims destroys the public’s trust in our federally funded healthcare programs,” said Special Agent in Charge Matthew Fodor of the FBI Tampa Field Office. “Working together with our law enforcement partners, the FBI will continue to prioritize safeguarding the integrity of the nation’s healthcare system and hold accountable those who try to profit from deception.”
I just covered the $760 million in unemployment insurance fraud discovered in Maryland, at least some of it likely paid out to identity thieves. The Somali daycare/childcare fraud scandal continues to spread across the country, from Maine to Minnesota to Ohio, a multi-billion-dollar network defrauding taxpayers.
“Kickback arrangements can corrupt legitimate medical decision-making and undermine the integrity of federal healthcare programs,” said Acting Special Agent in Charge Ricardo Carcas of the U.S. Department of Health and Human Services. Carcas is with the Office of Inspector General (HHS-OIG).
He added, “HHS-OIG, working with our law enforcement partners, will continue to investigate improper billing and kickback schemes to protect both Medicare and Medicaid as well as those served by these programs.”
Uncovering and punishing fraud should be a major state and federal priority this year.
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