The various clinics -- including Manassas Medical Center in Doral -- have filed more than $1.1 million in false Medicare claims for fabricated HIV infusion treatments in McCray's name, records show.
McCray admitted to The Miami Herald he has been abusing the system by selling his government-issued health card number to Medicare-approved clinics for years.
Normally, an HIV patient would need intravenous drug therapy such as immunoglobulin once or twice a month, but the actual number of treatments, type of drugs and precise dosages would depend on the specific condition of the patient.
The notion that a patient would need such treatments multiple times a day, multiple times a week is preposterous, according to medical experts.
What's even more remarkable about McCray's scam is that HIV-infusion therapy isn't medically necessary, thanks to the powerful antiretroviral pills.
''We hardly use infusion therapy today at all, because treatment has advanced so greatly,'' said UM's Dr. Fischl, noting that antiretroviral drugs became the ''cornerstone'' of HIV/AIDS treatment more than a decade ago. ``For 99.9 percent of the time, infusion therapy is medically unnecessary.''
But Medicare officials said they can't dictate to physicians or patients whether they should use HIV-infusion treatments or another type of therapy. Under the law, Medicare is required to approve prescribed medication that is considered ``reasonable and necessary.''
Agency officials stressed that HIV infusion therapy such as immunoglobulin is covered under Part B of the Medicare program, whereas antiretroviral drugs are not covered under that section or the relatively new Part D prescription plan. (Still, other federal dollars, through the Ryan White CARE Act, are available to low-income patients with HIV or AIDS to help pay the average $10,000-a-year cost for antiretroviral pills.)
''The law says if it's reasonable and necessary, we pay,'' said Don McLeod, a Medicare spokesman, in an e-mail.
``We want practitioners to have access to medical technologies that would benefit their individual HIV patient's situation, so it wouldn't make sense for us to do a national coverage policy that could potentially limit that access.''
Bottom line: Medicare still continues to pay South Florida clinics for multiple HIV infusion treatments, which cost from $1,500 to $3,000 per therapy, because the government program allows them -- regardless of whether the claims are legitimate, according to the FBI, Health and Human Services' Office of Inspector General and federal claim records.
On the morning of June 18, McCray was spotted by a Miami Herald reporter and photographer entering and leaving two different clinics that provide HIV infusion therapy.
Medicare records confirmed that both clinics -- Manassas Medical Center, 3900 NW 79th Ave., Doral, and ORD Medical Center, 8578 SW Eighth St., in South Miami-Dade -- billed the healthcare program for treating McCray on the morning of June 18.
Manassas Medical, located in Suite 326 in a huge office park known as the Atrium Plaza, submitted $475,000 in HIV infusion claims with Medicare for McCray and other patients from February through June, according to claim records.
ORD Medical, in a storefront office in a strip center off Calle Ocho, billed Medicare about $500,000 for HIV infusion treatments for McCray and other patients from early June to mid-July, records show.