How Medicare And Medicaid Fraud Became A $100B Problem In The U.S.

In an exclusive investigation, CNBC takes you inside how fraudsters are stealing Medicare and Medicaid funds through a wide variety of criminal operations. Special agents from the Office of Inspector General (OIG) show us how brazen these schemes have gotten from burying stolen Medicare funds in PVC pipes under a home to setting up a fraudulent business in the same building as the OIG. A convicted fraudster who served time for health care-related crimes says it’s “very easy” to make millions and stay under law enforcement’s radar because the fraud is so rampant. In a Miami shopping mall that’s been the targeted of OIG investigations, CNBC finds a medical supply company that’s billed Medicare more than $2 million in a small glass-enclosed office with someone sitting at desk, which investigators say is typical about fraudulent operations are set up. Annual Medicare and Medicaid fraud is estimated at more than $100 billion.
Senior Investigative Producer: Scott Zamost
Correspondent: Contessa Brewer
Editor: Steve Banton
Photographers: Oscar Molina, Marco Mastrorilli
Audio: Juan Merlo
Graphics: Michael Schwartz
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How Medicare And Medicaid Fraud Became A $100B Problem In The U.S.

[@coreyashley4949]

I'm a tax paying veteran. This country allows the working class, tax paying citizens to be victims of grand disservice and unethical theft. While many of these people do get away with this, it's terrible and embarrassing to know that the rest of us are always on the hook for medical payments.

[@antoniovaldez1972]

I am a tax paying astronaut

[@Anthony-kn8cn]

Exactly l had insurance and a pre existing condition of stenosis and scoliosis and didn't have a 1,700 dollar copay for a Dr. ordered scan to see how much worse thing's had gotten. Needless to say l left the hospital with no help and to date still deal with the condition. I asked for help and I've had to take crap job's because of my condition. This definitely hits home for me personally.@ Corey Ashley

[@aronob]

Man , jail for 12 years , that guy most likely got out already for good behavior reduced sentence, and got the rest of his cash he hid deep in the bunnies lol 😂 he’s gone with the cash stash for sure

[@anamegoeshere]

short answer is, THEY DON'T CARE ABOUT YOU OR ANYONE ELSE.

[@joyceboisvert9167]

Did you know veterans are suppose to get certain benefits and when they fought in the passed 20 years laters they took all benefits away from them i seen this happen to a friend of mine who wanted to get a houxe he was in the service for 4 ywears and when he applied they refused to give it to him he was entitled for it florida took alot of veterans benefits away which is very wrong

[@Bat_Boy]

As a person who has used social services funded by tax payers, this makes my blood boil too. At sometime in your life, you might legitimately, absolutely NEED these services…and here are people stealing that tax payer money. 😡

[@LassieFarm]

Yep and lotta them different color than you 👍 LOL. Isn't that awful

[@paidsurveys6561]

@@LassieFarm no problem when the Senators and corporations and billionaires rip it off what color are they .

[@shinji1264]

Not just any ppl.. "Americans" stealing it 😂

[@martingo2680]

And these people are rich already. The hospitals are overcharging and stealing. It's like stabbing us twice. Ridiculous

[@veryslyfox]

Thank the Democrats. They want to keep expanding free healthcare, and want to keep pouring taxpayer money into the healthcare system. It just invites fraud

[@yuglobalcitizen2246]

Yet I had to pay $2700 out of pocket due to high deductible insurance provided by my company when I fractured my wrist then visited ER, the Dr wrapped my wrist and gave me pain killer. I simply not qualified for Medicaid because I make"too much" money as regular blue collar worker. I didn't wanton see Dr last week when I had sore throat and coughing my lungs out because it will cost me over a hundred out of pocket. And I have friend who is visiting nurse told me he went to see this patient who has Medicaid yet lives in penthouse in a building of Manhattan, the living room so huge that they put a grand piano in the center. How the heck people like that can get free medical and I have to avoid Dr after I pay thousands a year for medical insurance? What's wrong of this country?

[@kl0wnkiller912]

My wife has to go to a pain management doctor. She is required to take monthly urinalysis tests in order to get her prescription for an opioid. They send the sample out for tests to an outside lab. My wife pays a deductible PLUS a 'co-insurance' payment for the testing. One day we got a bill in the mail from the lab that does the testing for four months of testing. Total cost? $20,000!!!! Turns out, the lab was inflating the cost 1500 percent because the insurance companies would only settle to pay 15% and since they paid we were not obligated to pay any more. I told them to stick their bills and reported them to the State Attorney General. They are no longer in business but had they not gotten so greedy who knows how many clueless seniors they might have continued to scam.

[@reconzar]

Its because they don't make an actual income, it goes into a trust so that why.

[@livelovely4681]

You missed the point of this video. It’s about medicaid/Medicare fraud, by medical "providers" not buy consumers.

[@kl0wnkiller912]

@@livelovely4681 Fraud is fraud though, but I get your point.

[@robertminor3460]

They have inside help

[@ronlaugsburger6991]

The people who really suffer are the people that really need good medical equipment , instead they get denied or are given the cheapest . The fraud penalties need to be increased and those in the supply chain.

[@zmartenfield]

I think this documentry is anti-semitic as many families rely on metioned companies, maybe business owners are taking a little advantage of medicare and midicade but 1-it's not private sector money and thier kids rely on this

[@shonedocumentarymanpitts9631]

Amen Jesus Christ is close I need help as well I pray hard

[@purge3883]

In America every government business there’s someone trying to steel your money

[@rockon8174]

​@Repent and believe in Jesus Christ dude...read the room! >:I

[@meetstepsisalcoholicdouche6167]

​@Repent and believe in Jesus Christ q

[@TheChrisgralnic]

We have to start treating fraud with more severe consequences

[@tonytsai844]

The penalty should be pegged to the amount f money defrauded by the individuals. So the more "successful" they are the higher the penalty and jail time and whatever else the courts can dish out.

[@velocityhawk224]

What really sucks is these thieves are making it difficult for people who actually need it.

[@BillAngelos]

It sounds like we need to greatly increase the penalty for defrauding the Medicaid program. Turning that 12 year prison sentence to 25 might be a good start. Seizing property, like that guys home where he buried the money wouldn't be bad either.

[@ryanblanchard2508]

Spot on 👌

[@bibbole5351]

100 years- is more like it-!!!!

[@diapers124]

Absolutely.. because are they really going to serve all 12... Get out for good behavior... I hope that they are prohibited from owning a business ever and they should do community service when they get out as part of their probation and have to keep paying money back for the rest of their lives because they took over a system where they've really taken away from the children and adults that need medical supplies right now because they're sickly... Not including the people who are healthy now but will also be in need one day 😭

[@chriswoods662]

they only recovered 2.5M ..the guy billed 49M(unless I'm mistaken)...but sounds like he has plenty more buried somewhere?

[@BillAngelos]

@@chriswoods662 Can't say I'm aware of the facts beyond this video. I'd love to see the legal system changed where if large sums of money aren't/or can't be recovered that they add 5 years per million dollars to the eventual sentence. Love to see them seize all the property too in an attempt to lower the financial losses.

[@luisurena1770]

I used to work for an insurance company in the medicare supplement/medicare advantage plans division and almost all claims calls from "providers" were for dme... and a lot of times i got calls from patients who got billed for dme that they didn't even need or got in the first place, this explains a lot.

[@nandhu2703]

Who are the providers?

[@luisurena1770]

@nandhu2703 any company that provides medical services, hospitals, doctors offices, nursing homes and in this case dme equipment "companies"

[@djp1234]

There are so many crooks in Miami.

[@captainkirk3000]

Florida has always been a haven for corruption, Ron DeSantis is a symptom, not the cause

[@fumanpoo4725]

Led by DeSatan in Tallahassee.

[@fumanpoo4725]

@Joe Langel Republican men...love other hard men.

[@shack12319]

The whole city was built from $ from crime of course there is

[@zaidhussain3293]

all those latinos will bring crime with them man

[@TheUnitedDrills]

I Seriously Laughed Out Loud When She Called & The Phone At The Desk Rang! ☎️😂

[@michaelmayo-vb5fl]

Lol hit her with the old trick 😂

[@TheUnitedDrills]

@@michaelmayo-vb5fl 💀

[@christopherreed3019]

I am currently doing my MBA in Healthcare Management at Temple University. In one of my classes, we discussed about Healthcare fraud and it became apparent that MEDICARE and MEDICAID were VERY prone to fraud.

[@SpaceRanger187]

Hopefully you learned how not to get caught

[@carloconopio6513]

Why your healthcare in us is not free compare to other countries i know its tax payers money? The us is the biggest budget in healthcare per capita compare all over the world. Wheres the money going?

[@christopherreed3019]

@@carloconopio6513 The AMerican Healthcare system is very complex. From payers to Providers to the middle man, eveything is very complex which is one of the reasons why we spend a lot on healthcare

[@kennethb6211]

There's a reason It's complex the more confusing you make something the more you can rip people off.

[@MM-km5zf]

@@carloconopio6513 US

[@blahblahblah7407]

Wait, why are doctors allowed to be selling patient info to ANYONE?! I'd be investigating that.

[@Rocanala]

It’s not just doctors. I’m sure staff assist in the fraud

[@tpeterson9140]

that's actually insane. where I live that information is extremely sensitive and a dr is not allowed to share ur information with anyone.

[@tonytsai844]

Guessing that the doctors are approached by the fraudsters and given incentives to steer business to the fraudsters for kickbacks. The legit patients are directed to the legit DME providers. Doctors can be greedy a-holes too. And if the doctors are ethical, that does not mean his employees with access to private patient data can not be bribed to give those patient information to the scammers. Just brainstorming how fraudsters can get their hands on real patient info, without going to the dark web.

[@hbarudi]

This should be HIPPA violation...

[@paulwolf7562]

They're not allowed to be selling or giving out medical information. It's in violation of the HIPAA Law.

[@mahakeem110]

Man they should get life in prison 12 years is just a bare minimum.

[@thevinceberry]

They should pick oranges for 12 years and all their assets confiscated, even families.

[@xbabu142x]

@@thevinceberry I'm confused as to why these people are not charged with conspiracy as well which is a mandatory 20 yr minimum. They seem to be running a criminal operation of their own volition and by their own will....

[@dudeguy818]

@@thevinceberry yep

[@daymajor4690]

GOP Senator Rick Scott should be in this video. He was CEO of Columbia/HCA when they defrauded Medicare, Medicaid etc. They were fined $1.7billion but Rick Scott left with $300 million in stock, a $5.1 million severance, and a $950,000-per-year consulting contract for five years.

[@Novastar.SaberCombat]

Most rich criminals are never caught. As this video notes... you only hear about a TINY, TINY, INFINITESIMALLY small percentage. And all those gobs and gobs of illegal dollars can be spent to make shady ops even more untouchable. ;) That's the system, baby! If it doesn't make dollars, then it doesn't make sense. If I had millions, I'd probably be forced to become corrupt JUST TO *SURVIVE*. Otherwise, trust me, the cartels, mafia, or yakuza would definitely wreck me, lol. Seriously, though. People need to be aware of those who are in CONTROL. Pro tip: it ain't the "governments" of any given country.

[@speedingAtI94]

nah. These who got caught were small potato. Big thieves don't go to jail. They go to the congress.

[@johnnycheung5536]

The Republicans who keep calling for the complete dismantlement of Medicare/Medicaid _are_ the same Republicans who benefitted handsomely for defrauding Medicare/Medicaid. Can't wait for a suffocating horde of "enlightened centrist" fake KZbin user account trolls to mass-accuse us for being the real trolls, smear us for being libs, cite this as the reason Medicare/Medicaid must be cancelled, and still claim with a straight face that _they_ - the people committing the very fraud - are the unsung heroes in this story.

[@brina6680]

You took the words out of my mouth lol rick scott is literally a snake. Shame.

[@dawnladuca7938]

Yes and now he is a SENATOR from Florida HE was elected Governor after this happened. He took the 5th 75 times!! Now He has a pamphlet out to "sunset" Medicare and social security

[@SunshineKK99]

Medicare should create a department where their representatives have to go out to the physical DME location to check it out before payment is rendered.

[@tioswift3676]

That would be impossible.

[@coolgamers2794]

Medicare and Medicaid do have fraud government auditor teams to verify yearly expenditure. However for law enforcement to really get involved would require probably millions of dollars lost already before legal actions are taken.

[@chriswoods662]

@@tioswift3676 not in this day&age...A.I> cameras idk "drones" it would'nt be hard to document in real-time?

[@daddy-orockstarmunchabunch3568]

Hard to do when only .02% of the money spent is for oversight and enforcement. This fraud is so prevalent because they’re underfunding the oversight

[@chriswoods662]

@@daddy-orockstarmunchabunch3568 it could be dealt with on the authorization side (ins companies) approve these services & rates are fed/state set ( by demographics) ...once approved that money is gone....*they need a way to stop it on the front end...but idk how

[@justinmiller1118]

We need much stronger enforcement and harsher punishment for large-scale financial crimes.

[@ZAGIDI]

Only sentence to 12,5 years? Seriously? And someone will be sentenced for more than 12.5 years for less than $50. SMH . This judicial system is discriminatory. What a shame

[@nicki8731]

He probably had a really, really good lawyer.

[@PlayfullWithFire]

It's a non violent crime. I think that is a reasonable amount of time for millions of dollars of fraud.

[@nicki8731]

yea i guess, but he did hurt people indirectly.

[@paniniman6524]

Better crime than robbery i guess. The government can also be blamed for lack of rules, so 12.5 years is reasonable.

[@BenzFrank]

well no, u picked the wrong crime clearly... take responsibility!.

[@joemacy2776]

This is sad that our hard earned tax dollars are being stolen like this. I want my taxes to go to the people who truly need it.

[@nm3547]

It's been this way for years, including within clinics. These are not the only people doing it, and hopefully this story breaks into wider curiosities, and findings.

[@tayl0r612]

What's even sadder is how widespread reimbursement fraud is in general. At least in the medical industry, businesses otherwise operating legitimately (dentists, doctors offices, hospitals) routinely slip in additional line items when the bill is going to insurance or government programs that cover the bill. Most patients don't care to look over the EOB when their amount due is $0 or just their deductible. If the bill is challenged, it's often written off as a mistake and "corrected". Insurance fraud is a massive industry ripe for fixing with modern technology.

[@nm3547]

@@tayl0r612 great point, about being fixed w technology.

[@Brujo2016]

Do you think it’s possible that some health clinics in the U.S. may be stealing money from Medicare/Medicaid?

[@nm3547]

@@Brujo2016 of course they are. & Directly from us, as someone else mentioned, through their coding process.

[@R4V3NBUDS]

Finally, it's being reported..the doctors that do this is unreal

[@pmfg875]

While shouting at patients, calling them liars, and refusing to diagnose or treat, just because they can.

[@Pterygotus]

This right here is why the government needs to nationalize healthcare. Anytime you get private companies able to take government money for services, you get a high potential for fraud or abuse.

[@saudigold50]

Aptly said. Stellar comment.

[@michaelmayo-vb5fl]

Lol you just answered ur own question

[@DimensionalGaming4]

100% of the time.

[@user-zp7jp1vk2i]

That new diabetic drug that is in demand for weight loss? A Dr. reg. to do practice in New Brunswick scammed hundreds of thousands of doses (he's in Boston). Canada DID jump on it and revoke his NB license. But scammers will attempt to scam. He pulled legally a half million bonus.

[@nicholasr39]

This doesn't happen in the UK.

[@LaughingOrange]

12x is too good of a return for the investigators. The problem is obviously too large for the current force to handle. They should hire more investigators immediately and get that number down.

[@arthurwintersight7868]

I agree. They should try to get the ROI down to about 4% annual return, which is gonna require a lot more agents.

[@vladrazym9955]

Its not 12x, its 12$ per 2c. So its 600x

[@krzysztofkonopka5559]

​@@vladrazym9955 no, they return $12 for every $1 spent on enforcement, and they spent only 2 cents for every $100 they spent. In other words, for every $100 dollars that HHS spent, they return about 24cents.

[@vladrazym9955]

@@krzysztofkonopka5559 ok, maybe I missheard this part

[@HingleMacCringleberry]

Greed and power are the ultimate corrupters of humanity.

[@roxiewatters1161]

Exactly

[@cuzheavy4079]

Letting people steal billions but harass people who can't pay past due medical bills smh

[@thelostcosmonaut5555]

Don't forget private ambulance companies and their rackets. They are one of the worst perpetrators of this and have the nerve to pay their employees next to nothing.

[@bannor99]

If you're going to talk about healthcare fraud in Florida & NOT mention Rick Scott, you're leaving out a sizeable chunk of the story

[@tioswift3676]

That case was over and done with years ago. Old news.

[@bannor99]

@@tioswift3676 Rick Scott deserves to have that massive fraud attached to him for the rest of his life

[@tioswift3676]

@@bannor99 Well clearly no one forgot. And it wasn’t him doing it he was the CEO of 30+ hospitals

[@3markaw]

@@tioswift3676 He also has a certain amount of responsibility.

[@tioswift3676]

@@3markaw I agree

[@BangkokZed]

Some years ago a finger cut sent me to the ER. Despite only needing wound dressing, I was billed $2700. An other doctor looked at my finger for 2-3 seconds which resulted in an extra charge of $285. The experience left me very skeptical of the medical system.

[@MrTom-kl7hy]

Truth. The American medical system is corrupt to it's core.

[@Eliastion]

@CW The funniest part is that most countries do have private healthcare as well - the public sector in most of the world is chronically underfunded, leading to long waiting times and sometimes also occasionally questionable quality. But the very existence of said public sector sets up a bottom line - the private sector needs to justify its existence by providing the extra service (faster and/or better quality) at prices that people would be willing to pay. In USA the healthcare and health insurance industries basically keep the population hostage - and this imbalance of power lets them set prices and engage in practices that would never fly elsewhere. In Europe, if you have some money, you probably want to get private insurance (higher end jobs tend to include it in benefits package) and you'll mostly be using private healthcare, but the combined contribution to public healthcare you don't use and private you do use will still give you better value for money than the insurance in USA. The one exception is if you are REALLY loaded, because the top level best-money-can-buy care in USA usually is really the best-money-can-buy of the world. Then again, if you're that loaded elsewhere, you'll probably be able to use the US (or wherever the best care for your specific problem happens to be) healthcare anyway - borders aren't much of a problem for the rich.

[@MuiKaHo]

@CW thank god for being canadian. i went to ER once when i was a kid and didnt have to pay a dime. only bad thing is... if you need surgery and it isnt an emergency you have to wait MONTHS. like my mom needed surgery to reduce pressure in her eyes so she can see... she waited 4-5 months.

[@nm3547]

@@MuiKaHo We have to wait long periods sometimes too. Even for a cardiac emergent case, sometimes.

[@___beyondhorizon4664]

3 weeks ago, I was referred to see a very young cardiologist, he talked to me for 3 min, sent me to do stress test 😡 don't even pretend to check properly

[@Cozmonimbus]

It seems quite a simple solution... to show Medicare recipients a quarterly or monthly explanation of benefits and on it, show a number or website to contact to report fraudulent charges. Incentivize their reporting. They'll get a certain set amount for each firm that they report that turns out to be fraudulent.

[@duaanekobe2773]

I get 2-3 calks a month from some people (from "pain management" to saying they are Medicare) wanting to send me something my doctor prescribed. As I get all medical care from the VA. I hang up. so no place or website to contact to report fraudulent charges.

[@thebastardgift]

Now add to that how Medicare is billed for services never rendered, nickel and dime amounts, and once reported with evidence, nothing happens other than Medicare continues to be billed for treatment never performed.

[@SL-lz9jr]

That kind of incentivazation could backfire too. Medicaid or Medicare recipients may be cash strapped and could start reporting legitimate businesses as fraudulent just to collect the reward.

[@itstayayg193]

Scamming is up there with murder. Sucks trust and integrity out of everything and destroys everything.

[@djayjp]

Would be so easy to prevent (nearly) all of this: require photo ID and a signature from the supposed recipient of the medical treatment. Or have them login to a Medicare site (just like an IRS login). Could include 2 factor authentication with their registered number and require a licensed medical doctor's authorization.

[@dianapennepacker6854]

I'm sitting here waiting for surgery paid by Medicaid. Heptorenal ‐ hopefully I can get a transplant. Its crazy people are getting away with this. I have to make sure I have an ID and fill out 100 forms. Someone might be trying to use mine but were denied.

[@SBTRKT88]

Exactly! Seems like a no brainer. I guess it just makes too much sense SMH

[@alvarocamborda4140]

As someone who works in healthcare. The older population would have some issues with this.

[@jamalwilburn228]

They can't because Democrats are against the use of IDs due to the belief minorities are too incompetent to be expected to have an ID. Looking at their constant push to prevent voter ID

[@johncolten4248]

@@alvarocamborda4140 Why?

[@harryo989]

why dont they go after the doctors who are selling the patients information????????

[@unholyrevenger72]

crooked Doctors are probably only a small portion, could be negligent disposal of documents but what I think is the biggest reason are breaches in a doctor's computer network

[@worldlife9834]

Fraud is big business in America. Our courts are clogged with minor drug possession cases.

[@Sohailali1]

The general population really needs these programs and few bad apples are going to cripple it. It's sad to watch good things going down to hell.

[@beng4647]

It happened a long time ago.

[@michaelmayo-vb5fl]

😂😂😂 they set aside a budget every year just for fraud 😂😂😂.

[@wayne8797]

Why do we pay taxes when the government just throws them out to crooks? Sure the crooks needs to be charged, but the higher ups at Medicare etc also needs to take responsibility. Put their jobs at risk and see how high they jump.

[@nm3547]

Unfortunately, the crooks are also in your Dr. 's and insurance office.

[@JeffCaplan313]

You're asking accountants to be doctors. And THAT is the fundamental problem. Making profits in a capitalistic society is antithetical to "do no harm".

[@sblijheid]

@Jeff Caplan Nonsense. Why can the for profit insurance companies sniff out fraud, but a government run program cannot. The government hires inept workers and has no fraud detection measures. We need less government.

[@uneed2see]

This is why healthcare is so expensive.

[@timothyplatt3300]

ehhhh no, this is WRONG to do, don't get me wrong... but the effect on healthcare prices is minuscule. The industry is greedy, they collude, and they're inefficient (culpable to fraud as you see in the video)... they're way behind in tech, good god I'm in the process of trying to find a PCP.... none of them are in sync w/ their online platforms and there is no sync w/ the insurance data systems... it's a mess. The care is good, but the system is a mess... these small players are not what makes it so expensive

[@Dacoldest23]

Absolutely not a reason

[@mazenperry145]

Couldn't be more wrong, please don't give wrong information out. If we want real change for that matter.

[@austinhernandez2716]

The reason it's expensive is because of capitalism. Price gouging. And you have no choice. You either get the healthcare or you die... Patents on it create monopolies too, so the prices are jacked up. The only solution is universal healthcare.

[@mukkaar]

Probably not even in top 100 reasons, but scummy and criminal none the less.

[@gabrielmartinez2455]

This is everywhere now, trust me. The entire city is thriving on fraud 😂

[@pi5tolpete989]

It's called greed

[@TL-wy1nk]

I think they should all get 20yrs. Make it a super felony.

[@pwu8194]

I went to a dentist for routine teeth cleaning. Instead of just cleaning my teeth, they wanted to do a deep cleaning, and more, to get all the $2000 Medicare Advantage is willing to pay per year. When I went to get my teeth cleaned, they drilled on four of my good teeth to put in fillings. It's insane. It's one thing to maximize their revenue, it's another to ruin perfectly good teeth.

[@juanwilliams3423]

This the real issue on alot of levels bureaucracy as well

[@AlexMint]

I've had dentists drill into teeth in such a manner. It's frustrating how little recourse there is for victims of such mistreatment.

[@shinji1264]

@@juanwilliams3423 All America's laws are outdated

[@genito1]

I am surprised you even knew they were drilling into good teeth. I just feel at the mercy of dentist every time I go or take my kids

[@andrelopez2514]

oww I am so sad to hear this, sadly this doesn't happen only where you are, I am from another country and we have the same issue, better get a reliable dentist and stick to him or they will even threaten your life with those invasive expensive procedures, my mom got an infection and that was very dangerous

[@nlocnil3602]

Everyday Florida man outdoes himself with new antics... what a consistent king

[@JerryDLTN]

Medicare (and Medicaid) should have current addresses, phone numbers and email adressses of Medicare and Medicaid patient/members. When a DME is ordered on the patient/members' behalf, a letter/phone call/email should be sent to the patient to confirm the order and if not confirmed or if denied, go after the provider.

[@chriswoods662]

ppl move ...a lot

[@isra3255]

They should be community service for life

[@thevinceberry]

Pick oranges for life.

[@Seanpfree]

In Tennessee I see SO MANY beyond wealthy people enriching themselves further in our BROKEN health care system.

[@wild_taco_gonecrazycorona9112]

How

[@Seanpfree]

​@wild_taco_ gone crazy corona several reasons from drug prices to the agreements that insurance companies have with health services. They make up an insanely high price knowing that insurance will pay a fraction of list price so they overbill at inflated prices. Also, sales ppl who refer ppl with insurance to rehabs across this country get 25%-40% of what the rehab charges for referring them, and logistically getting them there by booking a flight. Companies like ACA in Nashville are part of the reason a rehab costs $2,000 PER DAY for the bed + the health care. That kind of thing is why hospitals charge twenty two dollars for an aspirin. Our system is broken and people are getting rich exploiting it.

[@americajordan8215]

They lie most of the time you can't even get a return call or meeting with anyone to discuss the issue even with evidence Los Angeles California 💔

[@BookofJob3XVII]

It’s only illegal to steal money from medicaid if uncle Sam didn’t get his share of the profits.

[@kl0wnkiller912]

They already did. The government has been robbing money from the Medicare and Social Security fund for decades. They basically stole the money we paid in and used it for something else. Pretty nuch exactly what they are arresting these people for.

[@user-tc4xy6jl7o]

10% for the big guy too

[@bladebrowntv7822]

Bingo

[@ronkirk5099]

Sounds like some minimum jail sentences of something like 25 years without parole for the multi million dollar frauds would do some good.

[@sebastianm.2901]

what isn´t a problem in america?

[@FairBeautyEssentials]

America is a Corporation, not a country

[@sarahwilliams4092]

How is it so "easy it's easy, easy" for them to just take it, but damn near impossible for patients to get fully covered without going broke themselves?

[@PN-ve9lf]

The very sad part this story didn't cover is how people who are dependent on this government insurance get poor coverage for their needs.

[@jennytugara9470]

My question is why it keep happening over and over? This is Tax payers money who work hard with short checks taking care of their families and someone play with Medicare money like this is painful😭😭

[@ThatGuyhigh2]

2:07 What just happened? A car just disappeared moving from the rear driver window to the front.

[@WitchgirlViolet1313]

12 years isn't enough jail time for the fraudster. Give them longer sentences, so they will think twice before agreeing to participate in the illegal business.

[@HackmeHacku]

Damn Florida just love insurance fraud!

[@fergman300]

crime pays.... gets 12 years in prison.... steals 120 million dollars. Basically paying the guy 10 million a year to sit in prison. While justifying an entire corrupt legal system funded by taxpayers.

[@jorjoperalta]

He's probably only spending a few years in prison and getting out early on parole

[@JeffCaplan313]

Yup.

[@williegilligan2661]

Why cant we add investigators like this, instead of IRS agents? If we follow the bills this should be easy.

[@EarlyBirdCraft]

Here I am, trying to get a refund from Amazon for $34 because of a porch pirate. I still don’t feel easy for trying to get the refund😟

[@joekeanetv]

Well, another reason to cut off Florida from federal programs, we already waste enough paying to rebuild their houses after the yearly hurricane.

[@theonlythingihavetosayis9333]

Classy take from people like you...

[@adifferenttake8351]

so true yet the fl governor talks about how fl is number one in the US for just about everything he considers to be good.

[@wilwoo821]

This is happening in sf nursing homes too

[@robertgibson3655]

From Cuba with love. Fraudsters and fraudulent businesses.

[@withonestonechannel]

6:24 "We'll call him Julio.." HAHA! Nice move Contessa.

[@paulomartins1008]

It stands to reason that the ability to create companies without enough information for these to point to their constituents for the purposes of accountability in a timely and expedite fashion is at the heart of most of the U.S.A.s economical woes. But what do I know.

[@shinji1264]

All of the us laws are outdated, immigration, gun control, Medicare lmfao and politicians take a million years to change one word on a piece of paper

[@sblijheid]

Yeah, what do you know? Bernie Madoff was over regulated and yet he ran a ponzi.

[@jovannaspann5914]

Here I am as a legitimate small business trying to get medicare certified which has taken me 2 years and counting to meet all the requirements to do business with CMS.

[@chriswoods662]

that's the easy' part...fire-inspection CO (for the building)...initial audit (while you're still pro-bono)..pass< open for business...the hard''' part will be getting authorization from 4 different ins.companies(manged care) .with 4 different criteria (for that) , dealing w/ their reimbursement-rate which will be lower than on your estimated-performer (business-plan) and their rate and authorizations will get lower ...every 2 years ...GL /// hmu if u have any questions

[@justintenney7227]

How can I get ahold of you Chris Woods.

[@chriswoods662]

@@justintenney7227 I can call ..do you have a business line?

[@johnkeller5163]

Medicare and Medicaid government workers should be held accountable for allowing for this obvious nonsense. There is no reason why invoices cannot be checked before payment with proof of services, patient confirmation, pricing audits, and revisions of services actually needed for goal of efficiency of servicea.

[@octonoozle]

I'm just going to guess here but maybe the penalty for this stuff isn't big enough.

[@eddiekulp1241]

They must have names and real S.S. numbers to work this racket . Are some supplying there's for a kickback or all stolen

[@LuckyDogProductions]

WE NEED UNIVERSAL health care and take the GREED out of the equation.

[@samsonchan1488]

Increase inspectors and inspections. If shutting down just one fraudulent DME company prevents MILLIONS in wasted taxpayer dollars, that would pay for dozens more inspectors. And yes, changing the overall system would help too.

[@MrBakedDaily]

As a person who can't get health insurance because I can't afford it how does this affect me

[@mimusic1853]

If your employed and income tax is being withheld from your check its your money going to these slim balls.

[@MrBakedDaily]

@@mimusic1853 good thing I quit paying taxes

[@nm3547]

The same way all medical fraud affects you. This doesn't just happen through thugs.

[@skyscraperfan]

Thanks for giving us new business ideas! 😀

[@mulan7015]

That’s why people should have online accounts to manage what charges are being imposed or renew their Medicad

[@JTSunriseMusic]

The American way: lie, cheat, and steal your way to success on the backs of others

[@MrHammer2088]

Who they buy the list of doctors and patients from? Aren't they illicit as well

[@jorge117100]

12 years prison time, they need to be locked up for life

[@bankergeorge]

Why

[@limpaway]

Oh now I know why there is a medical supply store that is super far from regular foot traffic near where I live. I always wondered how they survive.

[@snowl22]

Reporter: "This is how the scheme works."

[@Patrick0900]

Good, we need people like this. 👍🏻

[@grapek909]

A lot of the stealing below begins with the help of homeless shelters and social services throughout the U.S. Some property owners (who receive the government funds from tenants) and government officials are involved with this theft.

[@devbravo4158]

Universal Healthcare would fix this

[@LordJulius777]

Nope.

[@DRAWKCABLLA]

How the hell does this man only get 12 years.

[@bronxtaskforce01]

Medicare and medicaid get robbed in broad daylight. For my dad's care, rehabilitation staff would spend less than an hour and bill hours of rehab.

[@RWaB7]

PUT THEM AWAY !

[@chadjones2308]

Excuse me did she just say frogulent?!?!? I think she meant to say fraudulent 🤣🤣🤣🤣

[@ktktktktktktkt]

2:45 "He thought he was a CEO but in fact he was just a crook." Why not both?

[@hahahaha-qu6uv]

It happened in Australia as well and not 1 doctor de listed or charged.Absolutley disgraceful

[@mcmarkmarkson7115]

Fraud above 1 million should just be ground for execution.

[@shockedinawe]

I know some people that do this, sadly the government isn't ontop of their ball with handing out medicare money.

[@emileneslo5695]

The state of Florida is also known for where all the old folks flock towards to live out their retirement life. These old people or their generation doesn't know any better and most aren't informed enough or kept up with the ever changing times. So I think most of these types of frauds is easily possible with such citizens.

[@reneedunn683]

Now I better understand why insurance keeps getting higher. They take from us what's being stolen?😮

[@BritenyGriffiths-le6nr]

This has completely took over the Internet

[@fumanpoo4725]

Rick Scott's entered the chat.

[@ThejOH007]

There needs to be better processes to catch these cases of fraud. CMS has the data. Investigate anomalies compared to legit practices in the same area, follow up with patients receiving services, verify addresses in conjunction with USPS. It’s not hard, the problem is it’s the government.

[@goma3]

Any request to increase regulation and supervision is staunchly denied as "more government interference". The inspector general office is understaffed by at least 2,000 agents and every year funding is further reduced. And Medicare frauds is peanuts compared with IRS fraud which is estimated at over $1.5 TRILLION. Yet when funding is increased to added much needed IRS agents to the books, you immediately get many Congressman and Senators calling it "government overreach"

[@laughinginthe90s]

The " smaller government" crowd would never let that increase in enforcement happen. they try to make it as difficult to solve issues like this as possible, then use the dysfunction that they nurture as justification for removing common good

[@vegassincity702]

Come to nevada Las Vegas and you'll see what medical scam is.

[@BrianGivensYtube]

Theres people like this ruining lives en mass yet I see people every day getting pulled over for doing 75 in a 70 just commuting to their mundane day job.

[@mrd.808]

That's 1/10 of a trillion USD, That's a lot of $$$$$$$

[@JTT840]

We can learn from this video. To not put your stash in your house, even if underground. Everything else the government could control dont have budgets. Set certifications to operate like Towing company's and Key locksmith do at county level. Enforce it at some level cause 100B could cover Healthcare for most Floridians.

[@MaLiArtworks186]

12 years is not long enough.

[@robby_itlo_amer2248]

I'm a Senior person. These EVIL 🙈🙈🙈. Don't have Conscience. This should be a Felony Offense.

[@terihairston4921]

So very wrong ! To steal money due to patients needs. 😢

[@tribulation138]

This is the problem when so much of our tax dollars is uncontrollable. To people and agencies have there hands involved and virtually impossible to track where any of the money goes.

[@Joshu796]

And yet they continue to dump money into it