Dive Brief:
- A network of health clinics bilked millions from the city of Miami, Miami-Dade County public schools, numerous companies and insurance providers through false claims for pain injections, reports the Miami Herald.
- 14 suspects were arrested Wednesday in the scheme that ripped off several insurers including Blue Cross Blue Shield, United Healthcare and Cigna.
- The scheme sought to steal $130 million, though the indictments say that all combined, those targeted and their insurers paid out about $15 million to the network, which ran about 35 different Florida health clinics between 2012 and 2015.
Dive Insight:
The Herald notes that this case stands out because usually the US attorney's office prosecutes healthcare fraud criminals who attempt to rip off Medicare.
However, the scheme was otherwise typical, the indictments indicate, using ploys such as stealing employees' names to file false claims on their behalf; providing kickbacks to patient recruiters; and utilizing physicians' licensing information.
The Herald reports that aside from those who orchestrated the scheme, most of the defendants in the case were paid a fee for allowing their names to be used to incorporate the clinics, to open bank accounts, and to cash falsely-obtained checks from Cigna, Blue Cross Blue Shield and United Healthcare.