Average HIV/AIDS-Related Medicare Claim Nine Times Higher in South Florida Than Nationwide in Second Half of 2006, HHS Report Finds
September 21, 2007
The average Medicare beneficiary living with HIV/AIDS in South Florida in the second half of 2006 had nine times more Medicare claims than HIV-positive beneficiaries nationwide, according to a report released this week by the HHS Office of Inspector General, the South Florida Business Journal reports. Federal health authorities attributed the difference to fraud in billing practices, according to the Business Journal.
Herb Kuhn, acting deputy administrator for CMS, in a written response to the report said that the agency has taken "aggressive recent actions" to reduce potential fraud in South Florida and is scrutinizing provider claims for HIV/AIDS before providing reimbursement. CMS reimbursed 66% of all claims in the region in 2004 and 27% of claims in 2006, Kuhn wrote.
According to the Times, officials said a federal task force on Medicare fraud has resulted in 34 criminal cases in the region involving $142 million in Medicare bills (Washington Times, 9/21). Ten Florida medical clinic owners in April were indicted for allegedly defrauding Medicare by improperly billing the program for HIV/AIDS treatments and medical equipment. The alleged leaders of the group, Armando Arias and Raul Rodriquez, are accused of committing fraud through Coral Way Professional Services and other companies in Miami-Dade County. They also are accused of laundering money and attempting to bribe witnesses to lie to authorities about their actions (Kaiser Daily HIV/AIDS Report, 4/5).
This article was provided by Henry J. Kaiser Family Foundation. It is a part of the publication Kaiser Daily HIV/AIDS Report. Visit the Kaiser Family Foundation's website to find out more about their activities, publications and services.