Medicare fraud rampant in South Florida

Cesar Romero was sentenced by U.S. District Court Judge Patricia A. Seitz to forty-six months in jail and remanded into immediate custody for his role in a multi-million dollar Medicare billing fraud scheme.

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Miami Woman Sentenced to 10-years for Role in $170M Healthcare Fraud Consiracy

On April 2, the same day that seven co-defendants were indicted (click here) for their roles in an $11 million Medicare fraud scheme involving HIV infusion clinics, Rita Campos Ramirez who had pleaded guilty in August 2007 to a $170 million conspiracy to commit health care fraud was sentenced to 10 years in prison.

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South Florida bills billions for HIV
Doctors and clinics in three Southern Florida counties account for most of the cash.jpg billions of dollars charged to Medicare nationwide for HIV and AIDS drugs and services, billing records show.

Federal health care regulators call the lopsided billing patterns "egregious" and warn that South Florida — particularly Broward, Miami-Dade and Palm Beach counties — is a potential hotbed for health care fraud, waste and abuse.

The Hospital Corporation of America (HCA) is the largest private operator of health care facilities in the world. It is based in Nashville, Tennessee, United States and is widely considered to be the single largest factor in making that city a hotspot for healthcare enterprise.

The founders included two members of the Frist family, which became very wealthy as a result. The former majority leader of the U.S. Senate, Bill Frist is a member of the family and has a substantial stake in the company. Most of his $20 million (or more) personal fortune was made through his holdings in HCA. Jack O. Bovender, Jr., is the Chief Executive Officer of HCA.

In the late-1990s, after a merger with Louisville-based Columbia Hospital Corporation which formed Columbia/HCA, the company was investigated by the government for Medicare and Medicaid fraud and paid a settlement of $1.7 billion, the largest fraud settlement in US history at the time. Then-CEO Rick Scott resigned but no criminal prosecutions resulted.

The name subsequently reverted to "Hospital Corporation of America." HCA abandoned the use of its name in its home market and instead promotes its Nashville hospitals under the TriStar brand.

On June 13, 2005, Senator Frist reportedly instructed the trustee managing his HCA shares to sell all of his stock. The sale took place in July, two weeks before disappointing earnings sent the stock on a 15-point plunge. In November 2006 HCA was acquired by Kohlberg Kravis Roberts, Bain Capital and Merrill Lynch Global Private Equity in the largest leveraged buyout (LBO) in history, adjusted for inflation.