Medicaid Fraud Scheme Aimed at California Homeless

Article from The New York Times written by Solomon Moore.

State and local officials in Los Angeles have uncovered a hospital scheme that used homeless individuals to defraud federal and state health insurance programs of millions of dollars. In order to receive Medicaid and Medi-Cal funds, at least three private for-profit hospitals in the Los Angeles area are believed to have participated in a fraud scheme wherein hospital patient recruiters would locate homeless indivdiuals in the Los Angeles area and pay them cash to come to the hospital to receive health care that would later be billed to the insurance programs. Often the homeless persons received no health care, and in some instances they receivedunneccesary health care that created health risks to the individuals. Court papers say that one individual received an treatment for a non-existent condition that caused a dangerous drop in blood pressure, and for her trouble, the individual was given money with which she purchased crack cocaine. Lawsuits filed allege that the scheme involved various hospitals and doctors who billed Medicaid and Medi-Cal for thousands of fake treatments. The scale of this fraud scheme is unusual and involved fake companies and contracts with people committing the fraud, kickbacks to doctors, and hospital coverups of the kickbacks. The nature and extent of this fraud scheme appears to far outreach the typical claims implicating smaller doctors’ offices; and, as at least three hospitals participated in this particular scheme, a question exists as to whether other hospitals or doctors in other parts of the country are involved in similar schemes to defraud state and federally funded health insurance programs.

http://www.nytimes.com/2008/08/10/us/10homeless.html?_r=1&oref=slogin