Inside the mind of criminals: How to brazenly steal $100 billion from Medicare and Medicaid

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Inside the mind of criminals: How to brazenly steal $100 billion from Medicare and Medicaid
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Medicare fraud runs the gamut: billing for unapproved Covid tests, genetic testing fraud, home health-care billing and a host of other schemes.

A nondescript suite of offices in a bland building tucked in a quiet Miami suburb seemed as good a place as any for a medical supply company to rent some office space.

When agents grilled the new owner, he admitted his name was used on corporate business records to conceal the identity of the real owners. Because the investigation is still ongoing and no arrests have been made, agents provided few details identifying the operation. But Pérez Aybar said it was shuttered last year before Medicare lost any money.That's just one of thousands of examples of how Medicare fraud is flourishing — not only in south Florida, but across the country.

He was arrested and charged with running an illegal pill business, according to agents who worked his case. The scheme involved multiple players who were all on the take and got a cut of the windfall from defrauding Medicare, the special agents said. Fraud is something Medicare and Medicaid take very seriously, Dara Corrigan, deputy administrator of the Centers for Medicare and Medicaid Services, said in a statement to CNBC.

To prove it was fraudulent, Carcas said he identified the referring doctors who supposedly signed off on patients who were billing their medical equipment to Medicare. None of the patients saw those doctors."They purchased a list of patient information," Pérez Aybar said. "They have doctors that they either are using as part of the scheme, they're paying kickbacks, or they may purchase a list of doctors' information as well, and then you start submitting the claims.

Pérez Aybar described what agents have found at the mall and elsewhere during previous investigations.

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