This is the face of health care fraud in America. A Miami businessman smiling as he counts stolen
Medicare money in this video secretly recorded by a government
informant. From sham storefronts to empty offices billing
the government for Medicare. What is this business? To buried millions in cash. The business of stealing Medicare and Medicaid
dollars has never been as brazen. What are we talking? $100 billion? That's probably a conservative number. Why Medicare fraud? Because it's easy. It's unbelievable. It's real easy. We're in south Florida today at the headquarters
of the agents charged with investigating Medicare and Medicaid fraud. And today they're taking us on location to show
us how those schemes work. Behind the steering wheel for this rare ride
along is Omar Pérez Aybar, Florida's special agent in charge of the investigation. So, Omar, give me a sense of where are you taking
me? So today we're going to head down the south
portion of Florida. He's one of some 450 special agents nationwide
from the Office of Inspector General, who fight a health care fraud
battle every day. Annually, estimated Medicare and Medicaid fraud
tops $100 billion. Around the world, it's known for its
postcard perfect beaches. But to federal investigators, Florida's famous
for its fraud. Won't be able to get. Massive theft from the government's health care
benefits. Far more than anywhere else in the nation. Okay. We're going to head over to a durable
medical equipment company, which unfortunately has been one of the lines of
business that is really keeping us busy here. Durable medical equipment, DME, think braces and
wheelchairs. Fraudsters buy lists of patients and doctors so
they can steal from the government. And with those two key pieces of information, they
can sit at a place that is open Wi-Fi and just start submitting claims to Medicare. In South Florida alone, Pérez Aybar says about 90%
of the DME companies are fraudulent. He had two businesses here. He had two businesses set up here. So we're at 241. But if you can notice, this is kind of the
business. It looks so nondescript. It is. And that's purposeful. And they want to try to keep us off their trail. A storefront once used to bilk the government out
of $48 million in a single year run by the guy counting the money. He thought he was a CEO when in fact he was just a
crook. His name is Jesus Garces. Back on the road, we head to the home where
Garces stashed his stolen money. This is where agents armed with a search
warrant say they made a startling discovery. Garces had hidden some $2.5 million in
cash in 12 PVC pipes under his home. And where were the pipes? So he had buried them in the foundation of the
home. There was a portion of the home that they were
remodeling. And so he put the PVC pipes in the ground. Was it just loose cash stuffed into the pipes? They had saran wrapped them or packaged them. They almost looked like bricks of cocaine. So hand would go in, a pipe would come out, hand
would go in, a pipe would come out. And it really was for us an indication of how
brazen this DME fraud is. Garces pled guilty to health care and wire fraud
and was sentenced to 12.5 years in prison. Back at headquarters, Perez Eibar shows me how
bold these health care schemes have become. The fraudsters here in South Florida are getting
so brazen that even in our own building, they decided to set up a fraudulent
DME company. So they don't even care that agents in charge of
investigating this Medicare fraud are in the same building. They're in our face. And we're just as brazen
back. Investigators shut down this operation. But the fraud is flourishing. Why do the fraudsters even need to set up a
storefront? It is Medicare regulations that you have to have a
business, especially in this case, for durable medical
equipment. We're at the Miami Merchandise Mart, which federal
agents tell us is a hotbed for these fake companies set up to bill Medicare for products
and services they never deliver. In this maze of tiny shops in a kind of indoor
flea market, we find exactly what investigators describe. There's a desk, perhaps there's a bit of a curio
with 1 or 2 different types of braces. They'll have the manuals that Medicare
requires, and usually there's some type of partition. If let's say we're talking about
orthotics, because the patient is supposed to come in and actually get fitted. That's the DME company. Most times we show up, there's nobody there. Or if there is someone there, they have no clue
what business they are representing or how it even operates. Agents shut one down and new ones pop up. In this business, which has been billing Medicare
for durable medical equipment, we find a young woman sitting alone at a desk. Hi, how are you? I'm Contessa Brewer. I'm with CNBC. What is this business? The woman says it's a medical supply store, but
she has nothing to do with the actual business. And the only thing she can show us right now is a
brace. She gives us a business card for the owner. I call the number, but it rings at the desk
inside. Hi, this is Contessa Brewer from CNBC. We just talked a minute ago. This is the number you gave me to call to talk to
Antonio. I leave a message for the owner who we eventually
reached weeks later. He says all the durable medical equipment is
ordered through another company after the patient sees a doctor. He refuses to give more information. But government records show the company has
billed more than $2 million to Medicare, mostly for wound care. That doesn't surprise this man. We'll call him Julio because he wants to conceal
his identity. Julio admits he knows a lot about stealing from
Medicare because it was his entire life for many years in Miami. Why Medicare fraud? Like, why was that alluring to you as compared to
other ways, other maybe even illicit ways to make money? It's easy. Did someone teach you how to game the system? A friend of mine, Yeah, he texted me one day. He called me and says, Look, I do this, this,
this, this. Are there a lot of people who are willing to break
the law? A lot of people. You'll be surprised. For money, they'll do anything. Is there a lot of money to be made? A lot of money. Millions of dollars to make. How much? Millions of dollars. How did that stack up? The risk versus the reward? Reward, it was excellent. There is still risk. Fraudsters get caught. The cases against them fill this massive evidence
room. So we do search warrants, secure evidence, make
sure we have to keep it in this type of pristine condition. So this is drawer upon drawer full of fake
documents. This is evidence that we seized during one of the
search warrants. I look around here and this is one warehouse in
one county in Florida. How big is this problem? South Florida, without question, is the ground
zero for health care fraud. But it's only one state. There are 49 others in territories where these
types of schemes are occurring . The Office of the Inspector general says of every
$100 spent by Health and Human Services in 2021, only $0.02 was spent on
oversight and enforcement. Yet its return on investment? $12 for every dollar it spends on enforcement. We asked the federal Centers for Medicare and
Medicaid Services about the widespread fraud. They told us, "We continuously work to
safeguard taxpayer dollars and strengthen program integrity in our operations by
identifying vulnerabilities in the system." What I was told
was that what we need is investigators and we need a lot of them. Why? It's hard for us to keep up with the amount
of fraud that is occurring. We just can't keep up. We need some additional resources.
Rick Scott where you at?
Donna Shalala where you at?
Sun sentinel did a three part investigation on this a few years back
http://interactive.sun-sentinel.com/plundering-america/
El 🐘 quien lo va mencionar?
It’s all those Clinics for seniors like Leon and la colonia that take advantage of it
Nothing new.
Take this with a grain of salt. It may have been the late 2000's or the early 2010's when this was first reported.
Here is an article from 2014
https://www.miamiherald.com/news/business/article1964403.html
Another from 2015
https://www.miamiherald.com/news/local/community/miami-dade/article91231277.html
I can't watch the video I'm at work but I'm pretty sure the university of Miami hospital was just tied up in some medical fraud along with Jackson Memorial Hospital. The title is absolutely true. Just another added layer to this corrupt ass city.
Older population,low wages you have a problem.