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On the trail of Medicare's most wanted

by Brendon Nafziger, DOTmed News Associate Editor | July 28, 2011
In the spring of 2008, a federal court convicted Gustavo Adolfo Smith of health care fraud -- according to the government's case, Smith reaped over a million dollars off bogus claims for durable medical equipment.

While awaiting sentencing, the court ordered Smith to wear an electronic monitoring device. On June 14, 2008, the device sounded an alarm. The police never found him. That same day, he boarded a flight from Miami to Santo Domingo in the Dominican Republic, and became one of the federal government's 10 most-wanted health care fugitives.

His picture and the details of his case, mentioned above, now appear on a new website launched by the feds in their latest attempt to crack down on a growing and profitable scam -- bilking Medicare and Medicaid.

Officials say health care fraud increasingly attracts organized crime, and involves an underworld where batches of stolen beneficiary numbers are sold on the street or traded online.

Currently, the Office of Inspector General for the Department of Health and Human Services says it's hunting about 170 fugitives who are accused or have been convicted of health care fraud. And it's hoping its new 10-most-wanted list, which launched in February and which copies a tradition started by the FBI in 1950, will help publicize cases.

"Someone knows where they are," Roberta Baskin, an OIG spokeswoman, said. "There's an outlet now to get info to us."

It's still in its infancy, though, so the OIG can't really say how effective it has been in generating leads. But the department says they have now seven fugitives in custody since the website started, and the office has received almost 8,000 tips so far this year.

Gerald Roy, deputy inspector general of investigations -- in effect, the man responsible for heading all investigations in this area -- says the site appears to be doing well. Already, it has had about 185,000 unique hits.

"Tips from the public have certainly turned cold trails into warm trails, and hot trails into hotter trails in our efforts to bring people to justice," Roy told DOTmed News, when we spoke by phone earlier this month.

Growing problem

The world of health care fraud is not how it was in 1995, when Roy joined the OIG, a position he came to from the U.S. Immigration Office.

He says when he first started in California, a known list containing 3,500 stolen Medicare beneficiaries' numbers was making the rounds, passed from crook to crook on sheets of paper. Now, it's swollen to more than 250,000 numbers, and it's being passed electronically "to those who indulge in health care fraud," Roy says.
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Gregory B. Holman

OIG Website???

July 28, 2011 11:03

It would have been nice if you had included the OIG website link in the article.

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Jason Eden

re oig website

July 28, 2011 12:28

this will get you started. you can go many different places, but a good starting point.
http://medicaresmostwanted.blogspot.com/index.html

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