Fw: Medicare billions going to Castro, Cuba

[Guest guest]

 

You learn from your mistakes...Today I hope not to learn_too_ much. 

Subject: Medicare billions going to Castro, Cuba

Perhaps this explains how Cuba pays for its health-care system. 

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WATCHDOGS: Solons worry Medicare

billions going to Castro, Cuba

June 22,

2012

Mark Tapscott,

Executive editorThe Washington Examiner

http://washingtonexaminer.com/watchdogs-solons-worry-medicare-billions-going-ove\

rseas/article/2500391

Two U.S. senators and a representative worry that billions of tax

dollars could be going to Cuba and other foreign countries via criminal

schemes designed to defraud Medicare and Medicaid.

The schemes often involve the use of “nominees,†individuals who are

paid to be fronts for the actual owners of corporate entities being

used in the fraudulent operation. By concealing the identities of true

owners, the approach invites its use to funnel tax dollars out of the

country.

In a letter made public yesterday to Marilyn Tavenner, acting

administrator of the Center for Medicare and Medicaid, senators Orrin

Hatch, R-UT, and Tom Coburn, R-OK, were joined by Rep. Roskam,

R-IL, said they fear billions of tax dollars are being lost annually as

a result.

“Clearly, the program vulnerabilities that facilitate billions of

dollars to be stolen from the Medicare program each year also allow for

some of that money to be funneled to foreign countries,†the three

congressmen said.

“While the fraud itself is unacceptable, the loss of American

dollars to foreign countries because of flaws in our system is totally

unacceptable. The American people deserve the peace of mind to know

that federal officials are doing everything they can to safeguard

taxpayers’ dollars and the Medicare program.â€

“Thus far, it does not appear that CMS has addressed the concept of

nominee owners, false storefronts, and shell companies in any of its

enrollment regulations or its Provider Screening statement of work,â€

they said.

Earlier this week, federal officials in Miami charged

in connection with a criminal operation that resulted in an estimated

$31 million going to Cuban banks.

“Prosecutors say , 46, was a key leader in a group that

funneled $31 million in Medicare dollars into banks in Havana — the

first such case that directly traces money fleeced from the beleaguered

program into the Cuban banking system,†the Miami

Herald reported Monday.

“Most of the money moved through an intricate web of foreign shell

companies before ending up in Cuba, to avoid being detected in the

United States, said investigators,†the Herald said.

Also earlier this week, federal officials announced the capture of

two other individuals who had been involved in multi-million dollar

frauds with overseas connections. In one, Irina Shelikhova was arrested

Monday at JFK Airport in New York when shetried

to re-enter the country from the Ukraine.

“From approximately March 2005 until July 2010, Shelikhova and her

co-conspirators allegedly paid cash kickbacks to Medicare beneficiaries

to induce them to receive unnecessary physicians’ services, physical

therapy, and diagnostic tests at the medical clinics,†according to the

Inspector-General of the Department of Health and Human Services.

“The co-conspirators created fraudulent medical records for these

beneficiaries and then filed false claims with Medicare for these

medical services, which either were never provided or were not

medically necessary,†the HHS IG said.

Shelikhova and her co-conspirators are believed to have defrauded

Medicare of as much as $70 million.

In the second case, federal officials arrested Cabello last

week when he attempted to re-enter the country through Champlain, New

York.

Cabello fled the country to Cuba in July 2008 after being indicted

on health care fraud charges. “Cabello submitted approximately $2.1

million in fraudulent Medicare claims on behalf of south-Florida-based

OB Pharmacy, Inc., and he received approximately $1.3 million in

Medicare payments,†according to the HHS IG.

“Before Cabello’s involvement, OB Pharmacy, a durable medical

equipment company that specialized in aerosol medications, submitted

$151,572 in Medicare claims and was paid approximately $58,653.

“Around April 2008, Cabello became vice-president of OB Pharmacy.

Investigators have concluded that OB Pharmacy submitted claims to

Medicare for services that were not rendered, including approximately

10 claims for deceased beneficiaries.

“Investigators interviewed physicians who stated that they did not

know the OB Pharmacy patients in question nor did they prescribe the

medication purportedly provided to them.â€

In their letter to Tavenner, Hatch, Coburn and Roskam cited a

University of Miami report that quoted a former Cuban intelligence

officer saying there are “strong indications†that the Castro

government aids Medicare fraud, especially in South Florida, and

provides safe harbor for individuals involved in those efforts.

“If confirmed, this indicates that Medicare program dollars are not

only funding international criminal syndicates, but may be helping prop

up the Castro government,†the congressmen said.

Back in April, Hatch and Coburn were joined in another

letter to Tavenner by representatives Boustenay, R-LA, and

Wally Herger, R-CA, on the nominees issue, and expressed concern then

that the problem was not being addressed.

The HHS IG “has expressed concerns regarding the use of nominee

owners and recommended that CMS take aggressive action to identify

them,†they wrote.  “Thus far, it does not appear that CMS has

addressed the concept of nominee owners, false storefronts, and shell

companies …â€