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Florida Healthcare Plus Liquidated Following Medicare Fraud Revelations

Florida Healthcare Plus, a Coral-Gables, Florida based HMO was in the news earlier this year after it was revealed that the business had been used to commit both Medicaid and Medicare fraud. This mass fraud was revealed after 11 South Florida citizens were federally indicted for fraudulently signing up enrollees who resided in both the Dominican Republic and Nicaragua for Medicare and Medicaid benefits. Florida Healthcare Plus employees were some of the people who were indicted, including the company’s former Chief Operating Officer. It is believed that between the years of 2011 and 2014, the indicted individuals used FHCP to steal over $25 million in Medicaid and Medicare funds. Florida Healthcare Plus tried to get back on its feet following the fraud in hopes of continuing to service the 16 counties that that it provided health care services for. Though FHCP was ordered into receivership for purposes of rehabilitation, at the beginning of January it was determined that FHCP was incapable of rehabilitation, and the company was ordered liquidated effective starting on January 1, 2015.

The Downfall of FHCP

FHCP is a health maintenance services provider that is headquartered in Coral Gables, Florida. FHCP only operates as a Medicare HMO and has 9,000 subscribers. The premiums and contracts under Medicare were administered through the Centers for Medicare and Medicaid services, a federal healthcare agency. In November 2014, 60 federal agents raided FHCP’s Coral Gables offices and subsequently filed a restraining order against FHCP. The raid occurred because months before it was revealed that suspicious activities were being conducted by FHCP employees and partners. This suspicious activity was disclosed to federal authorities after FHCP conducted both internal and external investigations into the matter. In fact, FHCP has been applauded for its decision to self-disclose the fraud that was occurring instead of trying to cover it up. After the investigations were completed, none of the indicted FHCP employees continued employment because they had been fired or fled Florida.

Once the indictment occurred, FHCP assumed that it would be able to continue its operations. In fact, in December the federal government placed FHCP under receivership in order to hopefully rehabilitate the fraud-plagued Medicare provider. At this point, FHCP had begun to work with new investors and had hopes that the ban on new member enrollment would be lifted by the end of the year. However, the discovery of Medicare fraud at FHCP has had debilitating effects on the company. While on June 30, 2014 FHCP had 537 Medicaid enrollees and 9,948 Medicare enrollees who generated $60.3 million in premiums, the company also lost around $3.2 million during the first half of 2014. In addition to financial losses, Florida’s Office of Insurance Regulation suspended FHCP’s HMO, and is no longer allowing FHCP to enroll new members because the company does not have an adequate capital surplus.

The liquidation of FHCP illustrates how the fraudulent activities of a few can have lasting, and wide reaching effects. Whenever you are dealing with legal issues related to Medicare fraud, or any other white collar crime issues, contact criminal defense attorney Jeffrey S. Weiner, P.A. in South Florida.

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