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Hunting health care fraud

Tuesday, December 20, 2011 - 02:31

Health care fraud is a multi-billion dollar scam spreading across the United States. Alanna Lavelle, an investigator for the insurance company WellPoint, reveals who runs the fraud rings and which cities have become hotspots.

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Medicare fraud is as sold those Medicare itself. Because it's a system that's based on trust is is relatively easy for perpetrators to defraud the system. Between three and 10%. Of dollars spent on health care end up going out the door and for a a lot of these criminals. Are very well organized and we have seen a lot of mom have come from the drug trafficking world. And they have switched over to Medicare fraud. Because there's less penalties it's easier to perpetrate the money is easy and it comes fast. Most recently we had a very large case on some bogus providers. That hit us really hard in the Atlanta area this investigation became like -- Kamal. Every timely we turned off one tax ID number another one would pop up. And we could actually map it out and traces -- the 95 freeway from Miami. Up to the 75 and 85 you could see where the PO boxes were being opened all around the city. Atlantic is a hot spot because of all the hospitals I think we have 161000. Providers. In the state of Georgia so it's a good place to do business and there's a lot of beneficiaries. To tap into for not only medical identity theft but. Any type of collusion with some of the more disabled patients. And it's a conduit as far as the transportation. You can get almost anywhere in the world. From Atlanta because the airport here. A lot of concentrated hot spots in the country where there's fraud just to name a few in Los Angeles there's a tremendous amount of durable medical equipment fraud. Pertaining to the -- providers and also legitimate providers that are just a fraud in the system Brooklyn New York a lot of ethnic organized crime circles that are perpetrating fraud. Houston Texas again DM -- fried. Louisiana Baton Rouge believe that are not actually has a high density area of health care fraud Detroit Michigan and Chicago and also northern Indiana has been huge problem with health care fraud. So we're we're targeting a lot of those areas doing a lot more fraud work and intensifying. Our proactive data mining. For those particular areas.

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Hunting health care fraud

Tuesday, December 20, 2011 - 02:31