KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Officials Crack Down On Medicare Fraud In Miami And Los Angeles

NPR: "When it comes to health care fraud, schemes that target Medicare are among the most common and lucrative. That's because the $400 billion federal program is a fat and easy target. The Obama administration ... has requested an increase for an effort to crack down on Medicare fraud. The government's effort to root out scams has proven successful in the Miami area, which leads the nation in Medicare fraud and in Medicare fraud prosecutions. ... Eric Bustillo, head of the economic crimes section at the U.S. Attorney's Office in Miami, says last year alone, his lawyers prosecuted nearly $1 billion in fraudulent Medicare claims. ... Three years ago, the Justice Department and the Department of Health and Human Services began setting up special Medicare fraud strike forces. The first was in Miami, and it was an immediate success, saving billions of dollars in fraudulent claims in one county alone." Other such strike forces have been established in Detroit and Brooklyn Allen, 2/23).

Los Angeles Times: "A former co-owner of City of Angels Medical Center was sentenced Monday to more than three years in federal prison for paying illegal kickbacks for patients recruited from the homeless on downtown's skid row. Robert Bourseau, 75, was sentenced to 37 months in prison and ordered to pay $4.1 million in restitution for his role in a scheme to defraud Medicare and Medi-Cal. He pleaded guilty in June to paying a recruiter to deliver homeless patients to his hospital for unnecessary medical services. The scheme was uncovered after an investigation into alleged patient dumping in skid row" (Winton, 2/22).

Modern HealthCare reports that the center's co-owner, Dr. Rudra Sabaratnam, and Dante Nicholson, a senior vice president at the hospital, have also pleaded guilty and await sentencing. "Mitts, who ran a phony assessment center that directed people from Skid Row's streets and shelters to the hospital, pleaded guilty as well and has yet to be sentenced" (Blesch, 2/22).

Meanwhile, the AARP Bulletin reports on Paul Greenwood, of the San Diego County District Attorney's Office. "To date, Greenwood and his colleagues have prosecuted more than 350 felony cases. The San Diego office is among only a handful of official elder abuse units in the country, and Greenwood has made it one of the most aggressive and respected foes of the crime." Greenwood also travels around the nation to educate people about how to protect against this abuse and "teaches those on the frontlines how to better enforce laws and prosecute offenders." Greenwood offers advice on how to prevent senior abuse and how to spot possible abusers (Ramnarace, 2/22).

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