South Florida still No 1 in healthcare fraud. Ripoffs cost Medicare billions a year

At a cost of billions, fraud is corrupting the new healthcare fields of telemedicine, substance abuse facilities and COVID-19 programs — but U.S. authorities also say it’s still plaguing traditional areas such as medical equipment supplies, home care and pharmacies.

South Florida continues to rank No. 1 in the nation for healthcare fraud, draining massive sums of money from the taxpayer-funded federal program, Medicare, and private insurance carriers, authorities say.

The region recently accounted for $308 million, or 20 percent, of the $1.4 billion in false healthcare claims nationwide, according to a six-week snapshot of criminal cases released Friday by the Justice Department in South Florida and other parts of the country.

Federal prosecutors in South Florida have also charged 52 defendants with healthcare fraud, or more than one-third of the 138 defendants prosecuted nationwide during that same time frame. Among them are dozens of doctors, nurses and other licensed medical professionals across the country — including many accused of receiving bribes or kickbacks for treating patients or filling prescriptions.

“A lot is said of South Florida as the healthcare fraud capital of the nation,” said Acting U.S. Attorney Tony Gonzalez, noting the high number of prosecutions in his office. “Whether true or not, we are clearly one of the most aggressive offices going after fraudsters. Indeed we are super aggressive in going after all types of healthcare fraud.

“The more ways that the government tries to help people in need, the more fraudsters try to take advantage of the new programs,” Gonzalez said. “The quicker the government has to dole out the money, the less stringent the controls must be. This, in turn, opens the door to fraudsters.”

Among South Florida’s healthcare fraud cases unveiled Friday:

▪ Rickey Delancey, 30, of Miami, is charged with conspiring to steal medical products such as N95 masks from his workplace, Mount Sinai Hospital. Delancey, who worked in the Miami Beach hospital’s supplies department, stole the masks and sold them for $55,000 to a buyer in California last year, according to an indictment.

As a result, at the height of the COVID-19 pandemic, Mount Sinai did not have enough supplies for nurses, doctors, staff and patients, prosecutors said. At one point, the hospital was down to only a three-day supply of N95 masks.

▪ Mimi Bieda, 62, and Levi Bieda, 36, of West Palm Beach, are charged with conspiring to commit $128 million of health care fraud. The Biedas, who owned a substance abuse treatment center and several drug testing labs, are accused of hiring a medical director who signed orders for medically unnecessary and expensive drug tests in exchange for patient referrals.

▪ Edward Pizzi, 40, of Miami, who owned Rios Medical Center and Union Medical Clinic, is charged with paying kickbacks to his employees to recruit Medicare beneficiaries to his clinics. The clinics allegedly used the identification numbers of these patients to submit claims for purported mental health therapy services that were not necessary or provided.

▪ Julio Cesar Betancourt, 31, of Hialeah Gardens, is charged with conspiring to launder $363,139 in health care fraud proceeds from a durable medical equipment company in Miami that was committing health care fraud, prosecutors said.

Lawyers for the suspects could not be immediately reached for comment.

With the fiscal year ending Sept. 30, the U.S. Attorney’s Office has filed healthcare fraud cases against a total of 196 defendants accused of filing $2.2 billion in false medical claims and collecting $488 million in payments from Medicare and other insurers.