By Catherine Larkin and Aliza Marcus
Bloomberg News
Tuesday, August 21, 2007

The federal government charged a South Florida company with fraudulently billing Medicare $170 million for infusions of HIV drugs.

The Health and Human Services Department, which oversees Medicare, and the Justice Department announced charges against the company, R&I Billing, yesterday in an e-mail statement. The agencies credited a new joint strike force designed to combat illegal billing and other schemes that push up costs.

Eliminating fraud may trim hundreds of millions of dollars a year from Medicare spending, which totaled $440 billion last year for the care of 43 million elderly and disabled Americans. Infusion therapy, providing medicines intravenously outside of a hospital or nursing home, is an increasingly common service for these beneficiaries.

"From roughly October 2002 through April 2006, HIV clinics in South Florida serviced by this biller, Rita Campos and her company R&I Billing, allegedly provided bills to Medicare that indicated patients were being injected with excessive amounts of HIV medications," the agencies said in the statement. "Based on the claims filed by Campos, Medicare paid more than $100 million for these fraudulent services."

About 1,200 providers of infusion therapy operate in the United States, including closely held national chains such as Coram Inc. of Denver and Critical Care Systems of Nashua, N.H. Walgreen Co., the largest U.S. drugstore chain, agreed in July to pay $673 million for Option Care, a provider of home and specialty infusion services.

The Florida arrest is "a shame because it taints the field," said Russell Bodoff, executive director of the National Home Infusion Association, a trade group in Alexandria.

Surprise visits to 1,500 south Florida suppliers of durable medical equipment in December found a "shocking" level of fraud, HHS Secretary Mike Leavitt said in May. Thirty-eight people were arrested, and more than 300 suppliers were thrown out of the insurance program because they did not meet basic requirements, such as keeping regular office hours.