Courts & Crime

Fraud? Miami gets half of Medicare's diabetes home-care funds

Medicare paid $520 million to Miami-Dade home health care agencies for treating diabetic patients, more than what the agency spent in the rest of the country combined, according to federal investigators.

The investigators suspect the disproportionate amount of Medicare dollars spent in Miami-Dade in 2008 is fraudulent because the county is home to just 2 percent of the nation's diabetic patients eligible for the federal program. The money may have been misspent in two areas: questionable claims for patients who either didn't need twice-daily nursing services to inject their insulin or who didn't actually have the diabetes.

The findings, issued Monday by the U.S. Department of Health and Human Services' Office of Inspector General, found that Miami-Dade providers accounted for just over half of the $1 billion that Medicare paid out nationally in 2008 for the treatment of homebound patients with diabetes and related illnesses.

Also raising a red flag for federal investigators: The county's percentage of diabetics is lower than the rate in other Florida areas with heavy elderly populations.

HHS Inspector General Daniel R. Levinson said "the recent growth in home health care services relative to the number of eligible [Medicare] beneficiaries indicates that it may be subject to fraud."

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