KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Medicare Fraud, Once A White-Collar Crime, Now Attracts Mafia, Violence

The Associated Press reports: "Lured by easier money and shorter prison sentences, Mafia figures and other violent criminals are increasingly moving into Medicare fraud and spilling blood over what was once a white-collar crime." Nationally, "federal investigators have been threatened, an informant's body was found riddled with bullets, and a woman was discovered dead in a pharmacy under investigation, her throat slit with a piece of broken toilet seat." But for the criminals, Medicare rackets offer more financial gain and shorter prison sentences than those for drug trafficking or robbery.

"Medicare scammers typically make their money by billing Medicare for medical equipment and drugs that patients never receive - and never needed. ... Most Medicare schemes are based in cities such as Miami, Los Angeles, Detroit and Houston. And rather than building an elaborate hierarchy like the Mafia or other gangs, many Medicare con artists use common street criminals to recruit patients and doctors, authorities said. A Medicare scammer could easily net at least $25,000 a day while risking a relatively modest 10 years in prison if convicted on a single count. A cocaine dealer could take weeks to make that amount while risking up to life in prison" (Kennedy, 10/6).

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