![]() Pérez Aybar said the inspector general is understaffed to handle the never-ending volume of cases. "I don't think the government can keep up," he said. He ended up pleading guilty to health care-related fraud and served three years in prison.Įven when the fraudsters get caught - the reward may outweigh the risk. I had houses, I had cars, I had watches," he said, adding that he routinely raked in millions from health-care fraud for more than a decade.Įventually, though, someone who knew him was caught and turned him over to law enforcement in exchange for more lenient treatment, he said. "I was low-profile, nobody knew about me. The same pills could be sold and resold multiple times with different phony patients, billing Medicare each time. He would then remove the label and "wash" the bottle to make it look new before reselling the pills to a wholesaler, which would sell them back to that pharmacy or another one that was in on the deal, he said. The scheme involved multiple players who were all on the take and got a cut of the windfall from defrauding Medicare, the special agents said.ĭescribing the scheme, the fraudster said he recruited patients to get a prescription from a doctor that was then filled at a pharmacy and paid for by Medicare. He was arrested and charged with running an illegal pill business, according to agents who worked his case. And people keep on - they get caught, they get out, and they'll do it all over again." For money, they'll do anything," he said, asking not to be identified for fear of retribution by people he worked with in the criminal underworld. "It's always been like that. The inspector general describes the fraud as prevalent and inventive, routinely ensnaring full-time criminals as well as legitimate doctors and health-care professionals gone bad, according to its annual reports. The amount at stake is staggering: Medicare spends about $901 billion a year on its 65 million beneficiaries, while Medicaid spends $734 billion providing medical coverage to more than 85 million poor and disabled Americans every year, according to the Centers for Medicare and Medicaid Services, which falls under HHS. The proliferation of crime has taxed the inspector general, which has just 450 agents around the country. Investigators say fraudsters have gotten more brazen in recent years - as Washington swiftly doled out trillions of dollars in Covid-19 relief funds and other aid in response to the pandemic. The fraud runs the gamut: billing for unapproved Covid tests, phony billing for wheelchairs, braces and other medical equipment, genetic testing fraud, home health-care billing and a host of other schemes. Personal Loans for 670 Credit Score or Lower Personal Loans for 580 Credit Score or Lower Best Debt Consolidation Loans for Bad Credit ![]()
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