NCPA - National Center for Policy Analysis

SOUTH FLORIDA BILLS BILLIONS FOR HIV

September 24, 2007

Doctors and clinics in three South Florida counties account for most of the billions of dollars charged to Medicare nationwide for HIV and AIDS drugs and services, according to the Inspector General for the U.S. Department of Health and Human Services.

Consider:

  • Health care providers in Broward, Miami-Dade and Palm Beach submitted $2.5 billion in claims to Medicare on behalf of HIV/AIDS patients in 2005.
  • By contrast, providers in the rest of the country submitted less than $1 billion in claims combined.

Federal health care regulators call the lopsided billing patterns "egregious" and warn that South Florida is a potential hotbed for health care fraud, waste and abuse:

  • Coral Way Professional Health Services Inc., for example, was charged with giving kickbacks to patients.
  • At the clinics, workers injected the patients with a saline solution but later billed Medicare for actual prescribed drugs, authorities said.
  • Overall, a federal task force aimed at rooting out Medicare fraud has resulted in 34 criminal cases involving a combined $142 million in Medicare bills in Southern Florida.

The fraud often happens in disenfranchised communities and sometimes involves illegal residents because they're paid cash for virtually no labor, says Benson B. Weintraub, a health care fraud lawyer based in Fort Lauderdale.

Source: Jim McElhatton, "South Florida Bills Billions for HIV," Washington Times, September 21, 2007.

 

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