The FBI, the Florida Department of Health, and local law enforcement agencies are investigating allegations that some storefront clinics in Broward County are paying HIV-positive homeless people $100 to $300 to undergo expensive and unnecessary medical tests which the clinics then bill to Medicare for reimbursement.
Medicare officials became aware of this rip-off in 2003 and have been attempting to end it ever since. The scam begins when clinic recruiters go to homeless shelters and drug treatment programs in the Fort Lauderdale area to find poor people who are HIV-positive. Many of these unfortunate souls already qualify for Medicare. The recruiters offer these “patients” cash to board vans to travel to the clinics for injections costing up to $6,000 a session.
The investigation has led to three arrests at the R.A. Medical Center in Little Havana, Miami-Dade County. In addition, Medicare has blocked $214.5 million in claims from these clinics and suspended more than 24 providers. Many of the clinics are still open for business, however.
”I don’t see why this isn’t being yelled from the rooftops,” said Ken Fountaine, a staff member at Shadowood II, a Fort Lauderdale shelter for the homeless with HIV/AIDS. “They’re taking advantage of the lowest of the low. . . . I don’t understand why they can’t go there and shut them down right now.” The Miami Herald has been following this story.
Medicare’s computers have been set up to ”red flag” and block certain providers and patients connected with this investigation. In the five months these new programming protocols have been in place, Medicare has stopped $144.5 million in payments to suspect clinics.
One bogus patient showed the Miami Herald bills that show she was given injections of immune globulin at $6,000 each. Medicare paid for at least two at $4,092.96 each. The patient said she and others were paid $100 each time they visited the clinic.
Many activists and AIDS specialists believe any clinic that pays people to become patients should be immediately suspect. Some doctors are even aware that their patients are being paid up to $300 a visit for one to three unnecessary trips a week to clinics. Desperation drives many of these homeless people into the scam.