Medicare scammers spread into Palm Beach, Fla., area    Phil Galewitz  The Palm Beach Post, Fla.    McClatchy-Tribune Regional News

Feb. 28--South Florida has long been known as the nation's epicenter of health care fraud, but the problem has largely been confined to Miami-Dade and Broward counties.

Until now.

As the population has shifted north, so have those looking to steal from private and government health insurance programs, federal authorities say -- particularly Medicare, hit for about $800 million in South Florida last year.

In response, the FBI and 15 other federal, state and local government law enforcement agencies formed the Greater Palm Beach Healthcare Fraud Task Force last fall to intensify and better coordinate efforts to attack Medicare fraud throughout Palm Beach County and the Treasure Coast.

"We are putting everyone on notice," said Shaun O'Neill, one of two FBI agents who have moved to the agency's West Palm Beach office from Miami in response to the region's growing number of health care scams.

The $460 billion Medicare program provides health coverage to 45 million elderly and disabled Americans annually. An estimated 10 percent, or $46 billion, ends up in the pockets of frauds, according to the Government Accountability Office.

What's more, 20 percent of all federal Medicare fraud prosecutions in the United States are filed in South Florida.

"We are the Super Bowl or ground zero of health fraud," said Bernardo Rodriguez, assistant special agent in charge of the U.S. Department of Health and Human Services' Office of Inspector General in Miami.

As a result, the task force not only employs tactics used in the battle against terrorism, but it enlists Medicare beneficiaries as well as doctors and other health care providers to fight the growing epidemic.

"Everyone has a stake here," O'Neill said. "It's all of our money going down the drain."

That's the way Norman Weatherbee sees it. In the past three years, Weatherbee, 79, of Stuart, said Medicare has paid more than $20,000 in services on his behalf that he never received.

He said Miramar and Miami companies have billed Medicare for air mattresses, nerve conduction therapy and a urinary leg bag that he never ordered nor received.

Medicare in the past two years has even paid hundreds of dollars to a St. Lucie County physician whom Weatherbee said he has not seen in 10 years.

Weatherbee and his wife, Joan, retired Winn-Dixie managers, are outraged that Medicare still gets scammed. They have reported the problem repeatedly, but the bogus billing continues.

"Something has to be done," he said.

By all accounts, health care fraud is only growing in South Florida, despite stepped-up efforts to attack it. According to the U.S. attorney's office, 245 people were charged in 2008 with Medicare fraud involving $793 million in fraudulent claims. That was a significant increase from 2006, when 111 were charged with Medicare fraud involving $138 million in claims.

Federal studies have repeatedly warned that the Medicare program is "highly vulnerable" to fraud, particularly in South Florida, where schemes center on expensive intravenous HIV medications and on equipment such as diabetic supplies, knee braces, wheelchairs, walkers, canes and hospital beds.

Law enforcement officials cite the area's large numbers of Medicare and Medicaid enrollees and the transient nature of the population.

"Health care fraud is a nationwide epidemic," said R. Alexander Acosta, U.S. attorney for the Southern District of Florida. "It is a serious problem here in South Florida, and it spans all regions from Miami-Dade County to the northern reaches of the district."

Combining resources in a task force allows law enforcement to focus efforts and "investigate and prosecute more cases," he said, employing lessons learned in the war against terrorism.

One advantage is the ability to act faster to disrupt fraud networks rather than spend years building a case.

"We are taking our anti-terrorism task-force model to get all agencies involved," said Jeffrey Danik, the FBI supervisory special agent based in West Palm Beach.

That includes Palm Beach County and the Treasure Coast, where more health care fraud suspects have moved to avoid increased scrutiny in Miami.

"These Palm Beach companies are, in turn, billing Miami beneficiaries with Miami doctors because they think no one is looking," Acosta said. "Bottom line is this: Regardless of where you are, if you are engaged in health care fraud, we will find you."

In 2007, the U.S. attorney's office in Miami established the nation's first Medicare Fraud Strike Force. Although the team doubled prosecutions, authorities admit the system has become so vulnerable that they cannot keep up with the billions lost annually to fraud.

Medicare has been easy to rip off because it functions under an honor system. Essentially, Medicare and its private contractors are required to review and pay bills within 14 days, leaving the system vulnerable to criminals who churn claims.

That's why the FBI wants Medicare enrollees to be vigilant in reading their Explanation of Benefits forms to make sure the program is not being billed for services they did not receive.
Copyright (c) 2009, The Palm Beach Post, Fla. Distributed by McClatchy-Tribune Information Services. For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA. Feb. 28--South Florida has long been known as the nation's epicenter of health care fraud, but the problem has largely been confined to Miami-Dade and Broward counties.