Medicare fraud is a crime that not only costs taxpayers dearly, but often endangers patients’ lives.
A clear example of the risk this entails for consumers is the diversion of medicines with containers that have been sprayed with chemicals to erase the labels.
“Take the label off whoever’s in there,” are some of the phrases heard in an undercover video taken by a government informant that shows a woman, her son and husband cleaning prescription medication bottles in a South Florida apartment. Florida.
They remove the labels from the bottles using charcoal lighter fluid and then attach another label with medical information to the bottle.
Bottles containing expensive medications such as those for HIV, medications that patients stopped taking in order to sell them, which is a dangerous practice.
“If patients do not take their medicine, the patient’s virus levels rise and it may affect their partners or the population itself,” said Fernando Porras, special agent of the Department of Health and Human Services.
Porras says the diversion of prescription drugs is just one of the methods criminals use to steal billions of dollars from the Medicare system each year.
“In South Florida we are unfortunately the epicenter of Medicare fraud,” Porras said.
Drug diversion works like this: A patient removes thousands of dollars’ worth of medication from his or her pharmacy and sells it to a third party for a fraction of the price. The latter then removes the information from the bottle and sells it to a wholesale distributor who sells it back to the pharmacy at a discount price.
“Some pharmacies know about this scheme or some pharmacies have no idea and that medication may be resold two or three times and these pharmacies can potentially bill Medicare two and three million for the same medications,” Porras said.
The three people in the video were convicted of conspiring to defraud the government and the illegal distribution of prescription drugs and served sentences of 2 to 3 years in prison.
In another case, Lázaro Hernández pleaded guilty to operating an elaborate prescription drug counterfeiting ring valued at $230 million and was sentenced to 15 years in prison.
“Normally we arrest the organizers of the scheme, the owners of the clinics. There are times when we also arrest the doctors who are participating in this scheme or the beneficiaries,” said Porras.
Therefore, the agent says that, to avoid problems, beneficiaries must be alert to the different frauds that occur when:
- They bill Medicare for devices they don’t need.
- They offer to pay you to enroll in a program or therapy that you do not need.
- Or they call you saying they are from Medicare and offer genetic testing.
“I urge the entire public, especially the beneficiaries, to review their account status,” said Porras.
That is the document that arrives detailing what treatments, services or medications were covered by insurance or Medicare. If you do not understand it, you can ask for it to be sent to you in Spanish or in larger letters. And if you suspect you have been a victim of Medicare fraud, report it as soon as possible.
