US Recoups Only $1 Million of $25M in Offshore Medicare Scam

Here in the United States, people who are a few years still away from retirement are nagged by the thought that the American public insurance program most people rely on when they hit 65+/-, may not be available when their time comes to apply. It’s rather inconceivable, then, that residents of other countries – like Nicaragua and the Dominican Republic – were enjoying these US healthcare benefits reserved to US citizens who are elderly or disabled, thanks to foreign medical centers that found a way around the rules.

Between 2011 and 2014, the US Medicare system paid out about $25 million in billing for services provided at the Nostrum Medical Center in Nicaragua. Working with at least two executives from Florida Healthcare Plus and other healthcare centers in Florida, the clinic encouraged patients to provide a US address so it could bill the Medicare program for services provided. More than 1,000 foreign residents enjoyed Medicare services during those years – signing up for post office boxes and mail-forwarding programs that made it appear as though they were in the US. Additionally, many used addresses of friends and relatives living in the US to get around the residency requirements.

Florida Healthcare Plus has not been charged with any wrongdoing, but two of its executives are considered conspirators in the case. This is an ongoing investigation but a total of 10 people, including a doctor and his son in Managua have also plead guilty to the scam.

The United States government, to date, has recouped only $1 million in the Nicaragua case. This is because Medicare fraud, though rampant, is not always easy to detect. Further, especially when the culprits are offshore, the stolen money is spent or hidden in non-accessible accounts. Seto Bagdoyan, director of audit services for the GAO (US Government Accountability Office) says that even when these fraud schemes are uncovered, the US “will hardly recover anything of the funds you paid out.”

If you have knowledge of any fraud being committed against the US government, there are ways you may be able to bring the information to light. In addition to becoming a whistleblower who becomes instrumental in stopping a criminal act, you may also be entitled to some of the proceeds recouped by the federal government in the lawsuit. Contact Begelman & Orlow today for a free consultation about your information. We can assist you in determining if you have a case worth pursuing.

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