Last week's Medicare Fraud Summit in Miami was reinforced by a record takedown of scam artists who were allegedly bilking the federal health-care program.
But some health-care companies charged that Medicare's own bidding procedures virtually ensure more fraud and failure.
Nearly 100 providers were charged Friday with filing bogus claims for service. Indictments cited fraudulent billing for home health care, HIV therapy and medical equipment.
Medicare officials said the 94 providers had attempted to bilk $251 million from the taxpayer-funded system. Friday's sweep -- which involved 350 federal agents in Brooklyn, Baton Rouge, Detroit and Houston -- was the biggest single-day fraud bust in Medicare's 45-year history.
"These criminals have siphoned valuable resources from the most vulnerable among us,'' U.S. Attorney General Eric Holder said at a news conference at the Medicare Fraud Summit. "With today's arrests we're putting would-be criminals on notice: Health care fraud is no longer a safe bet.''
But some summit attendees said the government's own bidding policies undermine Medicare and ultimately hurt patients.
"Medicare is not listening to the concerns of the elderly or the accredited and licensed durable medical equipment providers," complained Robert Brant, president of Accredited Medical Equipment Providers of America.
Brant added, "Medicare allowed out-of-area, inexperienced, financially bankrupt companies to win with desperate 'suicide bids.'"
"The only thing that has changed is that Medicare lowered their financial qualifications and bids are now much lower than manufacturer's cost," Brant charged.
Representatives of the industry trade group, the Florida Alliance of Home Care Services, also were in attendance and called the Medicare bid rules unsustainable.
Calling the summit itself a fraud, the Doral-based association protested the event.
"Medicare said it was only going to allow financially sound companies to win the bid, yet, for example, large national firms on the verge of bankruptcy with $250 million in debt, due in two years, were allowed to win," FAHCS President Roger Ribas said.
Ribas added:
"Medicare bidding will create fraud because at 40 percent to 60 percent reductions in reimbursement and by the including of known fraudulent companies, we can be assured the only way to not lose money, let alone make a profit in Medicare, will be to commit fraud.
"No real company can exist with 40-60 percent cuts."
Outside the Knight Center, which hosted the summit, protesters waved signs, one of which read: "No Experience + No Location + No Financials = BID WINNER."
Earlier in the week, Rotech Healthcare of Orlando was awarded 17 new Medicare bid contracts, despite the fact that it has lost $267 million in the last two years and owes $514 million to creditors, 15 months into a current three-year Medicare contract.
"This again shows that Medicare is only looking at the lowest bids and not a company's ability to stay in business while attempting to provide products and services to the elderly," said AMEPA vice president Jack Marquez.
Friday's summit included an appearance by U.S. Health and Human Services Secretary Kathleen Sebelius, as well as educational panels featuring law enforcement officials, consumer experts, providers and key government agencies.
Future summits are planned in Los Angeles, Las Vegas, Detroit, Boston, New York and Philadelphia -- other hotspots for Medicare fraud.
With the expansion of government-subsidized health care under new federal laws, officials in Washington say they are more determined than ever to root out corruption and inefficiency.
"Today's arrests send a strong message that attempts to defraud Medicare will not be tolerated," Sebelius said Friday.
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Contact Kenric Ward at kward@sunshinestatenews.com or at (772) 801-5341.
