For fraud to be classified as Medicare fraud, the fraudster needs to ask and obtain resources from Medicare to which they do not hold the right. Unfortunately, the number of Medicare scams is huge, but some frauds surpass the competition by far. Thus, read the following lines and learn about the largest Medicare frauds in US history. Even though the frauds were carefully planned, the masterminds behind the schemes were caught red-handed at some point.
HIV Infusion Fraud
Back in 2010, Raul Ramirez was found guilty for 12 counts of committing health care fraud, 3 counts of money laundering, and 1 additional count of conspiracy to commit a health care fraud, resulting in as much as $24 million-sum of embezzled money. What he did was pay HIV patients to sign papers that they were treated for a range of different conditions even though they were not.
In exchange for money, they allowed Ramirez to use their Medicare numbers and claim compensation. Surprisingly enough, this scheme lasted for years, and certain differences in securities made the job of the FBI easier and brought him to justice. All the billings were signed to one name of now a deceased doctor, which was more than enough to raise suspicion.
Nursing Homes Fraud
Filip Esformes was a chief of a carefully networked fraud scheme that managed to take as much as 1 billion dollars from Medicare. He developed a network where he paid the doctors to refer their patients to the nursing homes and assisted living facilities, he was either directly or indirectly in charge of.
By abusing their rights to various Medicare benefits, he managed to build a fortune on their torment, since they were treated poorly in inappropriate conditions. What he was convicted for was bribing the regulator for the information on when the inspections were to go to the centers he operated, and he served 5 out of 20 years until he was commuted by Donald J. Trump.
A Florida health care executive was convicted on 20 criminal counts in another 1-billion-dollar worth Medicare scheme. According to Scott Cooper Miami Beach director, even though Rick Scott is in charge of the ongoings in the region, we should emphasize that this type of scheme is omnipresent and that some scammers operate worldwide using the same technique nowadays.
Namely, what they did was get in touch with numerous individuals across the state reaching to them via landline phones. Subsequently, they asked for their Medicare numbers and offered durable medical equipment for compensation. That way not only did they earn a lot from selling what was already free, but they also had the opportunity to charge it additionally via Medicare claims. Fortunately, some of the organizers have been put to justice, but a significant number of similarly functioning fraudster groups still operate.
Unfortunately, the list we have introduced you to will have to be updated soon. Medicare is a system created for a noble cause, and a portion of informed individuals like to see it as an opportunity to fill their pockets with money. Hopefully, articles such as this one will serve as a warning sign, not as inspirational material.