Saturday, February 24 , 2018, 6:10 am | Fair 32º


Diane Dimond: Health-Care Fraud and America’s Newest ‘Most Wanted’ List

We can all become active in cracking down on one of the fastest-growing crime sectors in America

In the unlikely event they make a movie of my life story, a good place for the opening scene would be the post office in Albuquerque, where my mother used to take me as a child. Scene One, Act One would be me making a beeline to the bulletin board displaying the FBI’s 10 Most Wanted list. The future crime writer was transfixed.

“So that’s what a murderer looks like,” I always thought to myself, leaning in to the grainy black-and-white photos. I would peer deep into the eyes of the fugitive bank robber or kidnapper to try to find a clue as to what made these men turn so bad. (Back then, the list was all men.) I admit it, I was a strange child.

Today, another fugitive list has caught my attention. Its complied by the Health and Human Services Department’s inspector general, and it highlights those involved with one of the fastest-growing crime sectors in America: health-care fraud. As our population ages and government programs literally pour money into elder care, this type fraud has become a multimillion-dollar-a-year problem.

Looking at the Web site brings back memories of my post office visits. The site has photos (in color!) of the 10 Most Wanted health-care fugitives. Two are women. And because this is the digital age, there is a videotaped message from the deputy inspector general for investigations, Gerald Roy, who says the feds are looking for 170 criminals who’ve defrauded at least $400 million from our health-care programs. But Roy only hints at who these people are.

“Some criminals may be hiding overseas,” he says. “But fleeing the country is not a get-out-of-jail-free card. We have a global reach. We regularly work with domestic and foreign law enforcement agencies to bring these fugitives to justice in the U.S.”

Here’s what Roy didn’t say, and what I glean from studying this Most Wanted Web site: A vast majority of suspects facing fraud charges hail from foreign countries. Many of them are now suspected of fleeing to India, Russia, Nigeria, Mexico, Cuba, the Dominican Republic and Colombia. They have names like Gautam Gupta and Anupal Gayen. Others have Hispanic surnames like Gonzales, Velazquez and Lopez. One of the women on the Most Wanted List is Ekaterina Shlykova.

All of them have been charged with various schemes to bilk Medicare or insurance companies for goods and services that were not needed, not prescribed or never even delivered to the patient. They preyed on people in states with large elderly populations, such as Arizona and Florida. They also operated in California, Illinois, Michigan, New York, Rhode Island and Texas.

I don’t bring this up as a way to bash foreigners. In fact, among those on the “Also Wanted” inspector general’s list is a brazen American psychotherapist from Hawaii who the feds say fraudulently billed about $1 million to his state’s Medicaid program and various insurance companies for therapy sessions he shortchanged or didn’t bother to conduct. He did the same thing in Colorado in the early 1980s. Carlos Warter was found hiding in Argentina last year and is now fighting extradition back to the States.

No. This isn’t about condemning the actions of all noncitizens, but facts are facts. One of the highest rates of health-care fraud in the country is in the Brighton Beach section of Brooklyn, N.Y., where a majority of residents are immigrants from Russia. In a recent story about a $250 million fraud scheme in Brighton Beach, The New York Times reported, “The city’s Russian-speaking immigrant population, many of whom grew up under a communist system that bred disdain for the rules, (has) ... a willingness to cheat to get around them.”

In Miami, the nation’s other hot spot for health-care fraud, a trio called the Benitez Brothers and 20 co-conspirators allegedly pocketed $110 million in ill-gotten Medicare payments. Most defendants have pleaded guilty, but the brothers — Carlos, Luis and Jose — are still at large.

The point in bringing this problem to light is to remind folks that crime-fighting can start with you. If a health-care provider asks you to sign a form for a service or a medical item you never got — physical therapy, a wheelchair, a scooter, a hospital bed, or elbow or knee braces — report it to the OIG Hotline at 800.HHS.TIPS. Suspect fraud if you get a notice from your insurance company that they paid for an undelivered service.

If you are one of America’s 25 million diabetics and you are getting too many lancets or test strips via those mail-order pharmacies many insurance companies make us use these days, chances are someone is illegally profiting from it. Chances are good that if a health-care provider is cheating you, they’ve cheated others — and investigators need to know about it to build a case.

And if you can, check out that spiffy Web site I found, and take a close look at the mug shots there. If you know something about one of the fugitives, say something! It’s time we all became active in fighting this multimillion-dollar crime.

Diane Dimond is the author of Cirque Du Salahi: Be Careful Who You Trust. Click here for more information. She can be contacted at .(JavaScript must be enabled to view this email address).

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