Medicare fraud

Florida is among one of the nation's top states in recovering money from health care providers suspected of Medicaid fraud.

The Justice Department calls it the largest criminal health care fraud case ever brought against individual suspects: Three people are accused of orchestrating a massive fraud involving a number of Miami-based health care providers.

The three facing charges are all from Florida's Miami-Dade County; they include Philip Esformes, 47, owner of more than 30 Miami-area nursing and assisted living facilities; hospital administrator Odette Barcha, 49; and physician assistant Arnaldo Carmouze, 56, the Justice Department says.

More Than 100 Charged In Florida In Health Care Fraud

Jun 23, 2016

In what the U.S. Department of Justice described as an "unprecedented nationwide sweep," more than 100 people in Florida have been charged with crimes related to Medicare and Medicaid fraud, the federal agency announced Wednesday. 

Hospital Chain Ends Long-Running Tax Dispute With Florida

Apr 13, 2016

A major hospital chain is settling a long-running tax dispute with the state of Florida.

Records show HCA Holdings, the parent company of the Nashville-based HCA, signed an agreement with Florida officials in late March to drop three lawsuits. The lawsuits relate to disputes over how much in corporate income taxes HCA paid to the state.

A fugitive from Miami who has been on the run for almost 20 years is back in federal custody after he was arrested in Nicaragua.

Florida Attorney General Pam Bondi says she was wrong to urge the U.S. Centers for Medicare & Medicaid Services to pay for high-priced and unnecessary drug screening tests from a company being investigated for defrauding Florida Medicaid of millions.

Seven hospitals in Florida have agreed to pay the federal government about $9 million to settle allegations they submitted false claims to Medicare for a minimally-invasive procedure commonly used to treat spinal fractures from osteoporosis, a news release from the U.S. Department of Justice says.

U.S. Sen. Bob Menendez has renewed his attack on the federal government's corruption case against him and a Florida eye doctor in court filings that accuse prosecutors of ginning up the 22-count indictment out of a "fixation on sex and salacious headlines."

Doctor In Menendez Case Seeks Bail Changes

Aug 25, 2015

A Florida eye doctor linked to New Jersey Sen. Bob Menendez in a corruption case is seeking changes in his bond conditions in an unrelated Medicare fraud prosecution.

Health care fraud sweeps across the country have led to charges against 243 people, including doctors, nurses and pharmacy owners accused of bilking Medicare and Medicaid, the government announced Thursday.

The dragnet spread from Miami to Los Angeles, Tampa and Dallas to Brooklyn, N.Y. Arrests were made earlier this week. Combining all the cases, allegedly fraudulent billings totaled some $712 million.

 A Florida oncologist was charged Thursday with giving cancer patients medications, including chemotherapy drugs, from other countries that were not approved by the federal Food and Drug Administration.

One of the top Medicare billers in the country, Central Florida cardiologist Asad Qamar, is the target of two lawsuits accusing him of systematic Medicare fraud, including padding bills and performing unnecessary procedures.

Florida Healthcare Plus, a Medicare HMO with 10,000 members, was declared insolvent Wednesday and turned over to state authorities.

In such cases, state and federal officials help patients move into other health plans or to traditional Medicare. More information is expected on that today or Friday.

Florida's insurance officials are recommending a state takeover and liquidation of Florida Healthcare Plus, a Medicare Advantage plan accused of submitting $25.2 million in phony bills to Medicare and Florida Medicaid.

 A former top executive at a South Florida health care company has pleaded guilty for his role in a nine-year, $67 million Medicare fraud scheme.

Christopher Gabel of Davie, former chief operating officer at Hollywood Pavilion LLC, pleaded guilty Tuesday to health care fraud conspiracy and conspiracy to defraud the U.S. government.

WellCare Health Plans, which paid more than $400 million to settle past accusations of health-care fraud, is once again being sued under the False Claims Act.

The whistleblowers in this case are a half-dozen former WellCare staff members, including the former Vice President of Care Management Dr. Kirk Cianciolo. All are represented by Tampa attorney Kevin Darken, from the same firm that handled the previous whistleblower case against the Tampa-based WellCare.

Associated Press

Republican-turned-Democrat former Gov. Charlie Crist isn't letting voters forget that Republican Gov. Rick Scott ran a hospital chain that paid $1.7 billion in fines for Medicaid and Medicare fraud.

Gov. Rick Scott’s leadership of the Columbia/HCA hospital chain is well known, as is the company’s record $1.7 billion fine for filing false claims for Medicare and other federal health programs.

But as he faces re-election, stories about a simultaneous investigation in the 1990s are emerging involving Scott and attempts to buy the then-publicly owned Tampa General Hospital, The Tampa Tribune reports.

The fraud scheme began to unravel last fall, with the discovery of a misdirected stack of bogus prescriptions and a suspicious spike in Medicare drug spending tied to a doctor in Key Biscayne, Fla.

Now it's led to two guilty pleas, as well as an ongoing criminal case against a pharmacy owner.

Medicare Scam Fugitive Now Most Wanted

Jul 8, 2014

 A Miami man has been added to federal health officials' list of most wanted fugitives.

Sandy De La Fe was indicted last year on charges of conspiracy to commit health care fraud and health care fraud. Investigators say De La Fe owned a Miami pharmacy and participated in a prescription drug fraud scheme that bilked Medicare out of millions of dollars.