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December 23 2015

Let's Just Call this the Rolls Royce of Medicare Fraud

Patrice J. Lee

In another episode of Americans exploiting our massive public assistance programs to their financial benefit, we learn that a 24-year-old from Florida has been convicted of scamming Medicare for $21 million, which he laundered into fake companies, uber expensive luxury vehicles, homes, and jewelry.

What could a young man living in Miami do with a Rolls Royce, Range Rover, Bentley, and a lot of cash, but live a splashy life?

Daniel Suarez ran a fraudulent Medicare billing scam. He reportedly paid Medicare patients and recruiters for their ID numbers then billed the federal insurance program for costly medications that were never dispensed. He pleaded guilty to conspiracy to commit healthcare and wire fraud.

This enterprising young man didn’t just buy luxury items, but funneled some of the money into a faux FedEX franchise by purchasing three FedEx trucks then claiming to operate routes using the vehicles.

The Washington Post describes what he did with:

To wit: he bought a Rolls Royce Ghost, a Bentley, a Range Rover, a Mercedes-Benz S63 AMG  and two unidentified luxury cars with some of the ill-gotten gains. (The coupe version of the Mercedes sells for $163,150, according to this web site, and will go 0 to 60 in 3.9 seconds. The Rolls sells for $289,250 to $321,900, according to Car and Driver.)

Suarez rolled around Miami in the vehicles himself but also leased them to high-end car rental companies in an attempt to make it appear that the vehicles were part of a legitimate business, according to the court papers. But he also bought two homes, more than a dozen trucks and $100,000 in jewelry, some of which he immediately pawned for cash. Suarez also ran up more than $2 million on credit cards and nearly $57,000 in restaurant charges, according to the documents, which were filed as part of Assistant U.S. Attorney Roger Cruz’s efforts to secure a 14-year sentence.

Suarez blames an aunt for getting him caught up in this scheme. He apparently, comes from quite a family. He reportedly joined his mother and aunt in running eight pharmacies in Miami that bankrolled their scam.

This scheme came to light as part of a nation-wide crackdown on Medicare and Medicaid fraud in which the Justice Department reportedly nabbed almost 250 people for defrauding the government of $712 million in false billings. More than 70 South Florida suspects were charged for bilking Medicare as the Miami Herald reports:

U.S. Attorney Wifredo Ferrer said the regional sweep was part of the largest-ever national Medicare fraud take-down in the past decade, with the South Florida defendants accounting for about one-third of all suspects rounded up.

Since its inception in 2006, the Part D program has gained popularity because it helps deliver prescription drugs to nearly 40 million elderly and disabled Americans, who buy them from pharmacies reimbursed by private insurers funded by Medicare. But predictions of potential fraud in the program — which accounts for just over 10 percent of Medicare spending — have turned out to be accurate because numerous pharmacies submit false prescriptions for anti-depressant, anti-inflammatory and other drugs.

In 2013, ProPublica reporters highlighted the vulnerability of Medicare’s Part D program, noting that insurance companies must pay for prescriptions issued by any licensed prescriber and filled by any willing pharmacy within 14 days.

It’s no surprise that scammers take advantage of Medicare. It’s important for federal agencies to be diligent in tracking down and prosecuting this wrong doing. But the real problem (aside from human moral failings) is that Medicare and Medicaid are massive federal programs that are hard to monitor. A genuine reform of the health care system, with more input from the free market, would make a great deal of difference.

Independent Women’s Forum’s mission is to improve the lives of Americans by increasing the number of women who value free markets and personal liberty. Sister organization of Independent Women’s Voice.
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