Miami Herald - December 18, 2003
Ashley Fantz, afantz@herald.com

"This is a sobering and disgusting way to abuse a system -- a very good system when used correctly -- meant to serve people who need these drugs and can only get them through the Medicaid," said Crist.

In fraud cases, a doctor and patient scheme to get drugs paid for by Medicaid. The patient may sell the drugs on the black market or to wholesalers who often adulterate the drugs and sell them to unwitting consumers. The doctor takes a cut of the profit or receives favors for participating.

The grand jury noted one case in which an offender brought a briefcase packed with $300,000 cash to purchase black market prescription drugs.

It's not unusual, the report said, for investigators to find pharmacy labels belonging to Medicaid recipients discarded in the trash of drug wholesale facilities. Solvents are used by the wholesalers to remove pharmacy labels without damaging the manufacturer's label, so that medicine can be resold.

"That should show how serious this is," said Crist.

According to the grand jury report, there are "few, if any, consequences to Medicaid recipients who sell their expensive medications to wholesalers." And Florida's efforts to combat the crime "pale in comparison to what other states" have done, according to the report from the Broward County grand jury.

"We'll be working with the Legislature to correct this and I am confident we will have their full cooperation," Crist said.

Col. James McDonough, Florida's drug czar, said he is working closely with Gov. Jeb Bush who fully supports legislative change to halt Medicaid fraud.

"Doctors who are involved in this are the lowest form of bloodsuckers," he said, because they reduce the market supply of drugs such as those used to treat AIDS and cancer.

The proliferation of infusion clinics has also contributed to the spread of this form of fraud, said McDonough. Drugs which treat HIV/AIDS need to be infused, or mixed in a solution which is intravenously administered. The grand jury heard from witnesses and watched surveillance tape of an elaborate scheme that uses infusion clinics as a background.

The clinics recruit Medicaid recipients to the clinic with an $80 to $100 payment. The recipient is given a prescription and directed to a pharmacy, which delivers the drugs to the clinic -- whether or not it is registered with Medicaid.

If an infusion patient is prescribed 40,000 units of medication, the pharmacy would deliver more infusion bags than necessary with lower dosages, still totaling 40,000 units. That's because the pharmacy can charge Medicaid for each bag.

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