Medicare fraud scheme abroad costs US $25M: 5 things to know

Shuttle bus ads proclaiming "Medicare for people living abroad," may be a little bit too good to be true.

At least that's what American expats living in Nicaragua likely thought when they tipped off U.S. Embassy officials to a Medicare fraud scheme that cost the U.S. $25 million and led to the conviction of two Florida healthcare executives, according to Bloomberg Businessweek.

Here are five things to know about the case.

1. Four conspirators will be sentenced in Miami on Aug. 27, two of which were executives of the now-liquidated Florida Healthcare Plus based in Coral Gables. The four conspirators are among 10 people who have pleaded guilty in the case, six of whom have been sentenced to prison terms up to four years. One person remains at large, according to Bloomberg.

2. The defendants were arrested last October, after the government shut down two related fraud schemes in Nicaragua and the Dominican Republic. The HHS' Office of Inspector General, the FBI and the U.S. Department of State are continuing the investigation in other countries, according to the report.

3. The U.S. lost $25 million between 2011 and 2014 for medical care administered to more than 1,000 foreign residents who enrolled in a Medicare Advantage plan run by Florida Healthcare Plus. The foreign residents used P.O. boxes, mail-forwarding services, or addresses of friends in the few Florida counties covered by the company's Medicare contract.

4. Recruiters for the fraud program, who held information sessions at hotels in Managua, Nicaragua, made up to $300 per enrollee in commission. In June, the U.S. Government Accountability Office found the recruiters had registered roughly 24,000 patients, according to the report.

5. About $1 million has been recovered from the Nicaragua scheme, according to the report.

 

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