Also in conjunction with the Miami summit, HHS announced Florida has been granted a Medicaid waiver that will help fund a demonstration program in which the state's Medicaid Fraud Control Unit will mine claims data for patterns that suggest scams. Federal rules currently prohibit Medicaid Fraud Control Units from using federal matching funds in such efforts.
As of this morning, agents arrested had arrested 36 alleged participants in schemes involving more than $250 million in fraudulent claims, the Justice Department said. The defendants run the gamut of healthcare players, including physicians, medical assistants and owners of companies.
The range of allegations fit the general profile of criminal healthcare fraud that has been rampant for years in South Florida and is spreading to other parts of the country, with beneficiaries getting cash kickbacks for their Medicare numbers and scammers submitting phony claims for HIV infusion services, home healthcare, physical therapy and durable medical equipment.
The government plans to hold additional healthcare fraud summits in Detroit, Boston, Las Vegas, Los Angeles, New York and Philadelphia.