Fraud Inc.
Like many hardworking immigrants, 39-year-old Eduardo Moreno arrived in south Florida with pennies in his pocket and dreams of striking it rich. By late 2006, the Cuban-born Moreno was running a fast-growing cluster of medical supply companies and clinics and living the good life, with a spacious lake-view home in Miami and a fleet of cars that included a $200,000 Rolls-Royce Phantom.
Crime is big business in Florida, generating more money than manufacturing. Medicare fraud alone adds an estimated $12 billion to the state’s economy. [Photo: Paul Taylor/Getty Images] |
Moreno and his fortune are both long gone. Investigators say Moreno’s businesses amounted mostly to an elaborate scheme to divert millions of dollars in fraudulent Medicare claims into his private bank account. According to a federal indictment, Moreno’s companies — Brenda Medical Supply, Faster Medical Supply and RTC of Miami — routinely recruited patients for the sole purpose of billing the government for drug infusion therapies and for medical equipment such as electric wheelchairs, scooters and therapeutic mattresses.
In many cases, officials say, the drugs were unnecessary or never administered and the equipment — including air mattresses costing $868 apiece — was never delivered. More than $7 million in Medicare claims remains under scrutiny.
Moreno, arrested a year ago on multiple fraud charges, isn’t around to speak in his own defense. He skipped out on a $450,000 bond and remains a fugitive.
But even if all $7 million in Medicare claims turns out to be spurious, that sizable haul makes Moreno just another bit player amid a host of fraudulent enterprises — healthcare fraud, mortgage fraud, consumer fraud, insurance fraud and other categories of white-collar crime — that collectively amount to one of Florida’s biggest industries.
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
By itself, Medicare fraud in south Florida adds up to big business. In 2007, for example, 197 people were arrested in south Florida and charged with submitting hundreds of millions of dollars in bogus Medicare claims. In one case, a Miami air-conditioning repairman posed as a pharmacist to bilk the government out of $14 million, claiming he was producing aerosol medications. In another, clinic owners allegedly pocketed $12.5 million in Medicare reimbursements, substituting saline solution for expensive HIV medications.
The prosecuted cases, says R. Alexander Acosta, U.S. Attorney for the Southern District of Florida, are just “the tip of the iceberg.”
In many ways, the fraud industry in Florida resembles the state’s legitimate business community — highly entrepreneurial, comprising mostly small businesses that collectively add up to a lot of economic activity. While crooked politicians and multimillion-dollar scams grab the headlines, experts say the majority of fraud schemes in Florida are committed by the white-collar equivalent of the petty criminal. “These people are often very entrepreneurial, hardworking, but they’ve found a way to break the law, and they’re not afraid to do it,” says Acosta.
Attaching a dollar amount to overall fraudulent activity in the state is tricky. Some experts cite an International Monetary Fund estimate that as much as 5% of the world’s GDP is generated through fraudulent business activity. As a percentage of Florida’s GDP, that calculation would top $36 billion. The Association of Certified Fraud Examiners cites a similar number — 5%, or another $36 billion a year statewide — as the estimated loss in corporate revenue from various forms of occupational fraud: Inventory and payroll theft, skimming, billing schemes.
But while the sums seem large and the cases generate big headlines, fraud in Florida isn’t, overall, disproportionate to the state’s size. In bank, internet and consumer fraud, for example, the state ranks from second to fourth in the nation — consistent with its population rank.
“The analogy of (white-collar criminals) being like the old free-spending cocaine cowboys is pretty much on the mark,” says R. Alexander Acosta, U.S. Attorney for the Southern District of Florida. [Photo: Daniel Portnoy] |
In the case of Medicare fraud, however, the money comes from outside the state — from the federal treasury. Assuming the stolen money isn’t immediately funneled into offshore accounts, the sums generated by the fraud flow in some degree through Florida’s legitimate economy, representing a net economic benefit to the state from crime.
And a look at several kinds of fraud that are particularly prevalent in Florida indicates that it pumps a significant amount of money into the state. Some federal officials estimate as much as 20% of the nation’s total Medicare fraud occurs in Florida, importing some $12 billion a year into our economy.
The ill-gotten gains don’t end up stuffed in mattresses. Many of today’s fraudsters deal in so-called “clean money” in plain view of bank officers and IRS investigators. Most Medicare fraud profits, for example, arrive via government check, are legally banked, invested and declared on income statements. And, of course, they’re spent in the broader economy, stimulating sales of luxury goods, real estate and other trappings of the well-heeled. Like Moreno, scam artists “are going out and living the good life,” says Acosta. “The analogy of (white-collar criminals) being like the old free-spending cocaine cowboys is pretty much on the mark.”
Another sector of fraud from which Florida arguably derives a net economic benefit is money laundering. Despite tightened bank secrecy laws, many experts agree that huge sums are flowing illegally in and out of Florida.
Charles Intriago, a former assistant U.S. prosecutor, founder of Money Laundering Alert newsletter and a leading authority on the economics of white-collar crime, estimates that $25 billion a year is laundered in Florida. The source of those billions is myriad: Drugs, fraud schemes, even terrorism finance. Much of the money, like the billions in bogus Medicare reimbursements, is pumped into our economy from outside the state and ends up fueling sales of condos, exotic cars, fancy restaurants and nightclubs and goods at high-end retail stores.
In addition, Intriago says $1.5 billion in laundered money arrives in Florida each year from corrupt Latin American and Caribbean officials and business operators. He points to two high-profile cases: A colonel working for former Peruvian intelligence chief Vladimiro Montesinos and Byron Jerez, former Nicaraguan tax commissioner, both of whom illegally transferred to Miami millions of dollars pilfered or extorted from government coffers.
“These guys are up here living high on the hog — apartments on Miami Beach, Key Biscayne — and their countrymen back home are starving,” Intriago says. “And there are plenty more just like them we’ll never know about.”
Florida International University finance professor John Zdanowicz says the latest laundering trick is to move money into or out of the U.S. by misstating the value of import or export items. A Miami exporter, for example, might ship $1,000 worth of pencils to Colombia, but the invoice will ask for $100,000 in return. Using a computer program he developed, Zdanowicz calculates that so-called trade-based money laundering in Florida topped $8.2 billion last year.
The cost of fraud to the state? In addition to the funds spent on law enforcement, economists and businesspeople cite other impacts. One national mortgage company pulled out of south Florida because the region was generating a hugely disproportionate share of the fraud cases the company experienced. Meanwhile, Stephen Morrell, a professor of economics and finance at Miami’s Barry University and a senior research fellow at Florida TaxWatch is concerned by how scams damage Florida’s reputation, which he says hurts legitimate business by discouraging relocations and new investment.
As a business proposition, fraud is likely to remain attractive, even luring criminals from other, riskier endeavors. Acosta explains it as “the rate of return versus the criminal exposure.” While a drug offense can lead to 20 years in prison (or perhaps a bullet in the head); a $1-million mortgage fraud conviction can lead to probation and community service.
On the lam: Eduardo Moreno lived the good life — until he was arrested on suspicion of Medicare fraud. He skipped out on a $450,000 bond. |
A correct assumption, says Shanna Van Slyke, a doctoral candidate at the Florida State University College of Criminology, who studies sentencing outcomes of white-collar crimes in Florida. She says judges often ignore sentencing guidelines, sparing non-violent criminals from jail time even when the monetary value of the offense is substantial. Judges are especially lenient, she notes, when the victim is the government (as with Medicare fraud) or a faceless corporation, rather than an individual.
“The public perception is that the risk of going to jail is low,” Van Slyke says, “which may be the contributing factor when someone crosses the line between a legal and a illegal business practice.”
Col. Vicki L. Cutcliffe, director of the Division of Insurance Fraud at the Florida Department of Financial Services, says schemes are growing in size and sophistication, with organized rings — some foreign-based — increasingly common. Recidivism is up. “As long as the rewards are high and deterrent is low,” she says, “these people will be out there, always looking to be one step ahead of us.”
And Florida’s wealth and entrepreneurial culture will likely keep it fertile ground for fraudsters. “People come here to strike it rich — legitimately or otherwise,” says former U.S. Attorney Marcos Jimenez, now a Miami attorney in private practice. “These scam artists realize that Florida is a much easier place to operate and to slip in and out of, than say, Omaha.”
Fraud’s Wide Reach Florida’s fraud schemes are creative and wide ranging. Here are some: |
|
Mortgage Fraud Insurance Fraud Bank Fraud Occupational Fraud Investment Fraud |
Business Fraud Medicaid Fraud Securities Fraud Consumer Fraud |