Six charged in $13 million Miami healthcare fraud

MIAMI (Reuters) - Six Miami-area residents have been charged for their alleged role in a healthcare fraud scheme that cheated the government out of more than $13 million, authorities said on Wednesday.

Florida, where such cases are far from unusual, has long been known as the capital of healthcare fraud since so many elderly Americans have retired to end their days in its famous sunshine.

The U.S. Attorney’s Office for the Southern District of Florida said the six suspects had been charged in connection with a Miami clinic, T & R Rehabilitation, that submitted $13.6 million in false and fraudulent claims to Medicare for infusion therapies for the treatment of HIV and AIDS patients.

The scheme was made possible because beneficiaries of Medicare, the federal health insurer for more than 43 million elderly and disabled Americans, were paid kickbacks to sign records saying they had received HIV infusion therapies when, in fact, they had not, the U.S. Attorney’s Office said.

It said four of the six suspects were arrested on Wednesday while two remained at large and considered fugitives.

One of the suspects, Joaquin Vega, is a doctor who maintained a Medicare provider number at the clinic to submit claims. Others include the owner of the clinic and the operator of its HIV infusion practice.

The FBI estimates that fraud accounts for 3 percent to 10 percent of U.S. healthcare expenditure per year.

A Thomson Reuters report released last October said that in 2007, when the United States spent nearly $2.3 trillion on healthcare and both public and private insurers processed more than 4 billion health insurance claims, fraud was estimated to reach as much as 10 percent of annual healthcare spending.

Reporting by Tom Brown; Editing by Jackie Frank