Despite Medicare not being available to people living outside of the United States, one Medicare provider skirted the system and ran up millions in Medicare costs from elderly people living in Nicaragua and the Dominican Republic.
Nostrum Medical Center, a Florida-based Medicare provider, convinced people living internationally to provide addresses located in the United States so that the company could bill Medicare.
People were lured into the scheme through elaborate advertisements in newspapers and plastered on vans that read, "Medicare for people living abroad." The operation ran from 2011 to 2014 and paid out $25 million from the U.S. government.
"Before the Nicaraguan scheme and a related one in the Dominican Republic were shut down last fall, the U.S. government paid out $25 million from 2011 to 2014 for medical care received by more than 1,000 foreign residents who signed up using post office boxes, mail-forwarding services, or the addresses of friends or relatives in Florida to conceal that they lived overseas," the Wall Street Journal reports.
"We were a little bit astonished by the brazenness of the conspirators in this case, particularly with their widespread and open marketing," says Shimon Richmond, the special agent in charge of the Miami regional office of the inspector general of the U.S. Department of Health and Human Services (HHS), which oversaw the investigation."
Americans temporarily living overseas noticed the advertisements and tipped off U.S. Embassy officials. After an investigation was launched, it was found that recruiters would collect $300 commission per enrollee. Ten people involved in the operation have pleaded guilty thus far.
"Ten people, including a Managua physician and his son, have pleaded guilty in the swindle; one remains at large," the Wall Street Journal reported.
"Four conspirators, including two executives at Florida Healthcare Plus, one of the companies that billed Medicare for the patients seen abroad, will be sentenced in Miami on Aug. 27. (Florida Healthcare wasn’t accused of wrongdoing.) The investigation is ongoing, with the HHS inspector general, the FBI, and the U.S. Department of State looking at other countries where Medicare scammers are recruiting patients."