Defenders reveal Livonia family's plan to rip off health care system
Local 4 Defenders show how criminals bilk millions from patients, government
DETROIT – A Livonia couple and their son figured out a way to steal millions of dollars intended to help the elderly and the disabled, and are now spending time in prison because of it. The Local 4 Defenders offer tips on how to avoid becoming a victim of medical fraud.
Starting in 2007, Emilio and Maria Haber, and their son, Alejandro set up clinics in the suburbs of Wayne County and found anyone with Medicare coverage willing to fake an injury to bill the government and split the difference, federal officials said.
The Haber's paid recruiters to find the willing "patients." Then, the recruiter and the patient would split $150 and the Haber's would bill the government for expensive, unnecessary procedures. The Department of Justice said the Haber's would even coach patients on how to complain about phantom nerve damage. They ended up billing Medicare for more than $6 million before being busted.
In June 2011, Maria Haber was sentenced to 15 months in prison as part of a plea deal. Emilio and Alejandro also pleaded guilty and could receive a maximum of 10 years in jail. Once they are released from prison, the Haber's will owe the government $1.1 million in restitution.
To avoid becoming a victim, or an unwilling co-conspirator of a similar crime, here are tips from the Local 4 Defenders:
Health Care Fraud or Health Insurance Fraud
Medical Equipment Fraud:
Equipment manufacturers offer "free" products to individuals. Insurers are then charged for products that were not needed and/or may not have been delivered.
"Rolling Lab" Schemes:
Unnecessary and sometimes fake tests are given to individuals at health clubs, retirement homes, or shopping malls and billed to insurance companies or Medicare.
Services Not Performed:
Customers or providers bill insurers for services never rendered by changing bills or submitting fake ones.
Medicare fraud can take the form of any of the health insurance frauds described above. Senior citizens are frequent targets of Medicare schemes, especially by medical equipment manufacturers who offer seniors free medical products in exchange for their Medicare numbers. Because a physician has to sign a form certifying that equipment or testing is needed before Medicare pays for it, con artists fake signatures or bribe corrupt doctors to sign the forms. Once a signature is in place, the manufacturers bill Medicare for merchandise or service that was not needed or was not ordered.
Tips for Avoiding Health Care Fraud or Health Insurance Fraud:
-Never sign blank insurance claim forms.
-Never give blanket authorization to a medical provider to bill for services rendered.
-Ask your medical providers what they will charge and what you will be expected to pay out-of-pocket.
-Carefully review your insurer's explanation of the benefits statement. Call your insurer and provider if you have questions.
-Do not do business with door-to-door or telephone salespeople who tell you that services of medical equipment are free.
-Give your insurance/Medicare identification only to those who have provided you with medical services.
-Keep accurate records of all health care appointments.
-Know if your physician ordered equipment for you.
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