The round up continued Friday night across South Florida and the nation as authorities made nearly 100 arrests relating to some $251 million in Medicare fraud. Officials say it is the largest such bust in history.
The crackdown has so far involved 33 South Floridians who produced $140 million in bogus claims. Arrests were announced in Miami by top Obama administration officials US Attorney Eric Holder and Health and Human Services Secretary Kathleen Sebelius, who spoke of tougher penalties and new ways to find the crooks.
But one man who knows the fight against Medicare fraud from the inside out, former U.S Attorney for the Southern District of Florida Alex Acosta, says prosecution is not the solution.
"General Holder is doing a wonderful job. The Department of Justice is doing great work, but ultimately that is not the answer. The answer is prevention. And that's really a question for Medicare. What will Medicare do to prevent fraud in the first place?"
Imagine putting your keys in the ignition and leaving your car door open in a parking lot at night. Whoever steals it has broken the law, but you've got to stop leaving your keys in the ignition. That's how the Medicare program is being described: it is made very easy to steal billions in health care dollars, as much as $60-$90 billion per year according to government estimates.
In other words, Holder prosecutes the crooks inspired by lax oversight from Sebelius’ agency.
“Medicare fraud is everywhere," explained Acosta, now the Dean of FIU's law school. "We are wasting billions and billions of dollars each and every. And the sad thing is that these are dollars that we really need for people in the system that need healthcare dollars.”
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Acosta launched the first task force crackdown years ago. Under his watch, in South Florida alone a dedicated multi-agency crew charged nearly 900 people involved in more than $2.5 billion dollars in Medicare fraud in just 5 years.
But Acosta knows government bureaucracy is slow to change. "It's so easy to commit fraud."
Most of the crime is done by invididuals billing the government or insurance companies for medical care or equipment that either wasn't necessary or never existed in the first place.
Acosta's team actually went to inspect 1,593 medical equipment companies and to his astonishment found a third of them were criminal enterprises. He thinks Medicare should verify who it pays.
"The inspections were not that in depth. Are they there? Are they open? Do they have a telephone? This is basic stuff? And the fact that Medicare certifies and pays to companies without making sure they're there is inexcusable. Now, Medicare has been doing a better job. But Medicare has to sit back and say 'How do we change a system to prevent fraud in the first place?'"
Sebelius says the President’s new Healthcare Reform Law will make it more difficult for the bad guys, and will give authorities greater tools to find the crooks. She has also just given Florida the okay to use new computer data mining techniques to root out fraud in the state Medicaid system as well.
And for his part, Holder put a tough face on the recent arrests despite the lack of controls preventing it from happening again.
"With today's arrests,” Holder announced, putting as tough a face on it as warranted, “we're putting would-be criminals on notice: health care fraud is no longer a safe bet."
