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Feds target Detroit area as HIV-Medicare fraud rises
Associated Press Writer
DETROIT -- In six months, a clinic collected more than $500,000 from the government's Medicare program for taking care of just 14 people.
Here's why: The clinic was recruiting and paying patients, mostly people with HIV, and then getting reimbursement for phony or unnecessary treatments, according to federal investigators.
"There are a lot of places that are paying patients to get their business," said Assistant U.S. Attorney F. William Soisson.
The government is fighting back.
The Detroit region is one of four areas in the country where a "strike force" - beefed-up teams of agents and prosecutors - will concentrate on Medicare fraud, a crime that costs billions.
"We know these strike forces work," Attorney General Eric Holder said in announcing them last week.
The Detroit area seems ripe for scrutiny. In a court filing, the FBI says Medicare has paid more than $10 million to "multiple clinics" suspected of billing for services that weren't performed or weren't necessary.
Three people were charged May 12 with paying Medicare beneficiaries, typically $50 to $250 per visit, to go to Livonia Wellness Services in Livonia, which opened in 2007 and closed last year.
Lourdes Fernandez, described as a clinic manager, arrived from Miramar, Fla., to carry out the scheme, according to the government.
"They hook them up with IVs and inject them with stuff," Soisson explained in an interview. "It looks like patients may have gotten vitamins and saline solutions, not what the clinic billed Medicare for."
Indeed, the clinic told Medicare it was treating HIV patients with drugs to strengthen immune systems and clear up eye infections, according to an affidavit by FBI agent Justin Shammot.
In February 2008, an informant wore a concealed recording device during visits. Money was openly distributed at the clinic or inside a minivan that was used to shuttle patients, Shammot wrote.
Soisson doesn't believe patients were in the dark about whether the treatments were legitimate.
"I think they knew whatever they were getting, or thought they were getting, wasn't necessary," he said.
A message seeking comment was left with Fernandez's lawyer, Humberto Dominguez of Miami. The prosecutor said plea deals have been negotiated, and the trio should return to court by late June.
Other Detroit-area clinics are being investigated.
"We expect results in the near future," Soisson said.
A spokeswoman for the FBI in Detroit declined to discuss how many agents are investigating health-care fraud but said it's a priority.
The government has seen "some very erratic billing coming from Detroit in the Medicaid and Medicare arenas, especially Medicare," Sandra Berchtold said.
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