Fraud proceeds support 'Livin' La Vida Loca' on the taxpayers' dime

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Ricky Martin wasn't singing about those who cheat the healthcare system in his number-one hit; but he could have been when you read about all the loot the government has confiscated from people charged with or convicted of healthcare fraud. Here's a sample of what the proceeds of their schemes have bought:    

Gregory Silvestri of Lake Worth, Florida, agreed last week to forfeit a $60,000 platinum and diamond engagement ring purchased after executing a $2.5 million Medicare fraud. And North Carolina "party mansion" owner Claude Verbal--who bilked Medicaid of at least $1 million-- gave up four pieces of diamond jewelry,including a seven-carat, $52,000 ring.  

Florence Bikundi, an excluded provider later charged with committing a $78 million Medicaid fraud, forfeited a humdinger of a home Maryland: A 7,300-square foot gated property valued at $927,000 complete with fountains, a pool and fake palm trees. Authorities also seized millions of dollars stashed in 46 bank accounts and towed away Bikundi's Cadillac, Mercedes Benz, Porsche, Land Rover, Range Rover and BMW.

Accused Medicaid robbers Colin and Andrea Chisholm lived in upscale homes, had bank balances of nearly $3 million and owned an 83-foot yacht. 

Osteopathic physician Christopher Gregory Wayne pleaded guilty to a $5 million Medicare fraud, which helped pay for his posh Miami house that served as a production studio for Playboy photo shoots.  

Then there was a sweeping asset seizure by the United States and the Dominican Republic from the infamous Benitez brothers, accused of bilking about $110 million from Medicare before fleeing to Cuba. Authorities snatched back more than 30 commercial and residential properties in this case, including a water amusement park, a soft drink distribution center, multi-unit motel complexes and waterfront condominium apartments. There was also (wait for it) a helicopter.

What happens to all this stuff? Some U.S. attorneys' offices dedicate staff to asset tracking and recovery, particularly for restitution. Depending on the type of asset and its value, it may be sold with the proceeds returned to the forfeiture fund. Or - if the government recovered the asset following a restitution order - the item may be sold with money returned to the fraud victim, such as the Medicare trust fund.

All this is necessary work, but it makes me cringe. Look at the hoops the government must jump through to recover portions of what's been lost and covert the goods back into cash. Do we really want the Department of Justice serving as a consignment shop for gently-used helicopters and bling?

And look at the prodigal lives criminals have led with their big bankrolls and shiny toys. It's infuriating. Criminals divert dollars to selfish ends while U.S. healthcare and the programs that finance it limp along. To borrow a phrase from Ricky, that's an upside, inside out arrangement.

All this begs the question of what taxpayer dollars should be funding in healthcare. So many public health problems could be addressed with the money lost to fraud. And we could make health insurance affordable for more citizens. Indignation about what fraud has financed--and what it leaves underfinanced--should fuel our efforts to stop it. - Jane (@HealthPayer)

Related Articles:
The cautionary tale of Florence Bikundi, an excluded provider
'Rock Doc' learns Medicare's no stairway to heaven
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Feds crack down on therapeutic services fraud
When fraud becomes a family affair