MEDICAID FRAUD
Florida probes Miami-area medical-equipment kickbacks
Medicaid investigators are targeting fraud in Miami-Dade County, zeroing in on questionable billing for medical equipment.
BY JAY WEAVER
jweaver@MiamiHerald.com
State investigators snuffed out more Medicaid fraud in Miami-Dade this week: They swept 12 medical equipment providers suspected of bilking the state healthcare program for low-income people by billing for oxygen concentrators that are not medically needed.
Investigators also visited more than 120 Medicaid patients, some of whom may have received kickbacks from medical equipment suppliers for ordering their products.
Some cases will be turned over to the state attorney general's office for criminal investigation, officials said at a Miami-Dade press conference Thursday.
Holly Benson, secretary for the Florida Agency for Health Care Administration, said fraudulent billing for oxygen concentrators is the latest scam ailing Medicaid, which spent $90 million on medical equipment in fiscal 2007-08. About 25 percent of that spending, funded by state and federal taxes, was in Miami-Dade.
''Every day we hear stories of Medicaid fraud and all the money that is stolen from our state,'' said Benson, who was joined by state Rep. Marcelo Llorente and other officials.
Medicaid has paid for medical equipment such as oxygen concentrators, feeding kits and electric wheelchairs and later discovered they were missing, unused or never received by the patients.
This week, Benson said she rode along with investigators to a Medicaid patient's home in Westchester. The patient told them that he had an oxygen concentrator to help him with his breathing and had other medical devices -- yet he was solicited by an equipment supplier to buy more of the same products.
''As a beneficiary and a taxpayer, he was mad,'' Benson said, ``and all of us should be mad.''
Unnecessary billing for oxygen concentrators has been a particular problem over the past five years, officials. Last year, Medicaid reimbursements for the concentrators exceeded $1.4 million in Miami-Dade, accounting for 17 percent of total expenses statewide for the devices.
In March, Medicaid investigators launched similar sweeps in the home healthcare industry in Miami-Dade, aiming to stop questionable payments to agencies that defraud the system.
The state inspected up to 125 home healthcare agencies, about one-third of all Medicaid providers in Miami-Dade. The providers bill for unskilled workers who are supposed to help homebound patients with bathing, medication and other basic needs.
Anyone who suspects Medicaid fraud may call the Agency for Health Care Administration at 888-419-3456.
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