Florida authorities arrest 18 in $26M pharmacy fraud ring

Law enforcement agents in Florida arrested 18 alleged participants of a widespread pharmaceutical fraud scheme that submitted $26 million in fraudulent claims to Medicare, but four others remain at large in Cuba, according to the Miami Herald.

The Department of Justice announced Thursday that charges had been filed against 25 Miami-area defendants who make up three Medicare Part D fraud cases. Authorities detailed a sprawling scheme they say was operated by two of the fugitives, Pedro Torres and Antonio Hevia--both of whom escaped to Cuba--in which patient recruiters were paid kickbacks to refer patients to 10 different Miami area pharmacies where staff members forged prescriptions and submitted false claims for medically unnecessary medications.

"Unfortunately, South Florida remains ground zero for these types of scams," William Maddalena, assistant special agent in charge of the FBI's Miami office, told the Miami Herald.

Federal investigators have identified Part D fraud as a "top area of concern," as the Office of Inspector General has pushed the Centers for Medicare & Medicaid Services to consider more Part D fraud controls. Previous reports have revealed a criminal pipeline to Cuba that is riddled with healthcare fraud.

To learn more:
- read the Miami Herald article
- here's the DOJ announcement

Related Articles:
OIG sets sights on Part D fraud amid rise in drug spending
OIG reports revisit questionable billing and fraud within Medicare Part D
Investigation reveals criminal pipeline to Cuba riddled with healthcare fraud