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Life Health > Health Insurance > Medicare Planning

Medicare scams multiply

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Wow, Medicare has really become a poster child for bad business. And that’s such a shame. Really, just scraping the bottom of the barrel, don’t you think?

If you’re like me, you might have received a flurry of letters from insurance commissioners warning consumers of such scams. Unfortunately, more often than not those most at risk of scams never get the warning. Hopefully, as an ethical advisor, you’re letting your clients know what’s out there.

Just taking at look at some of the recent statistics on these scams, the numbers are staggering. Since the Medicare Fraud Strike Force began operations in March 2007, more than 560 people have been indicted of submitting false claims to the Medicare program totaling $1.2 billion.

Most recently, there has been news on the airwaves and in print regarding a doctor in the Detroit area who has been sentenced to 72 months in prison for his part in a Medicare scam. A so-called patient recruiter, who was also implicated in the scheme, received 40 months, according to the Department of Justice.

Judge Gerald E. Rosen ordered Dr. Toe Myint, of Bloomfield Hills, Mich., to repay the more than $3.1 million he stole from Medicare. Myint will also serve two years of supervised release following his prison term. Rosen ordered recruiter Terrence Hicks, a Jackson, Mich., resident, to pay more than $4.9 million and serve three years of supervised release following his term.

Fifty-six-year-old Myint is one of three Michigan doctors who have been convicted of unrelated health care fraud offenses in just the last three months. The convictions were secured thanks to the efforts of the Medicare Fraud Strike Force, which as offices in Detroit.

From late 2006 to early 2007, Myint, Hicks and others submitted $4.2 million in fraudulent Medicare claims for services they claimed Myint provided at an infusion clinic, Sacred Hope Center, which had been set up solely to defraud the Medicare program. Hicks, 43, also worked at a second clinic, Xpress Center, which falsely billed an additional $2.3 million.

During his trial, Myint was shown to have routinely prescribed unnecessary medications to patients at the clinic, medications that were often never administered. Myint, the only physician employed by Sacred Hope, was asked by its owners to prescribe drugs they knew Medicare would reimburse at a high rate.

Other evidence presented at trial showed that recruiter Hicks paid kickbacks to patients in exchange for their seeking care at the clinics. Hicks recruited patients from downtown Detroit and drove them to the clinics, where they signed documents claiming they had received services that were then billed to Medicare.

A total of 11 defendants have been convicted so far for participating in the scheme. Daisy Martinez, an owner of the two clinics, was sentenced to 96 months in prison.


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