Sometimes it's enough to simply ask the question, isn't it?

Just when you think U.S.-Cuban relations couldn't get more surreal (take a look at these two videos - h/t to the Cuban Triangle - chronicling two Cuban state security agents' revelations from their collective 40 years inside the Cuban dissident community), it turns out they absolutely can, and they will.  Here's a clip from The Hill's report from a Senate hearing earlier today:

"Sen. Chuck Grassley (R-Iowa) grilled federal officials Wednesday about the Cuban government's possible ties to rampant Medicare fraud in south Florida.

"During the hearing, Grassley referenced a report from the Institute for Cuban and Cuban-American Studies at the University of Miami raising questions about the involvement of Fidel Castro's regime.

The report paraphrases a "high-level former intelligence official with the Cuban Government" as saying that there are "strong indications that the Cuban Government is directing some of these Medicare frauds as part of a desperate attempt to obtain hard currency."

I worked for the Senate Finance Committee when Senator Grassley was chairman of that committee (which oversees Medicare).  He took his investigative responsibilites quite seriously.  So I'm a little flabbergasted to see him go out on a limb over what seems to me such slim pickins, as we say in the South.  (Though, to be fair, 7 of the 10 top Medicare fraud perpetrators are Cuban American, so I can understand why he'd want to explore the subject further.) 

The short document prepared by the University of Miami's Institute for Cuban and Cuban American Studies (ICCAS) and referenced today by Senator Grassley can be found, and quickly read, here.  Here's a sample of the ironclad, single (unnamed) source research conducted by ICCAS on the subject, based on an interview with a former Ministry of the Interior official from Cuba:

"Cuba has contrived ways to benefit from leasing doctors, nurses, teachers, and security agents abroad; more recently, Cuba has also found ways to capitalize on large-scale Medicare fraud, possibly committing economic warfare on the United States."

Now that's impressive: fitting both the words "possibly" and "warfare" into the same sentence.

"The question should be posed: What makes South Florida different from any other region and can account for the troubling number of fraudulent claims emanating from the area?"

Well, I'm stumped.  I mean, it's not like South Florida actually attracts a higher proportion of Medicare-age transplants from around the country or anything. 

"It seems clear that the Cuban Government is partially responsible for the disproportionately high number of cases of Medicare fraud in the region."

"It seems clear" is exactly the sort of phrase a researcher should only use after providing conclusive, reinforcing evidence of their conclusion.  Just because you examine a handful of theories, discuss them, and then pick your favorites after a conversation with one former Cuban official who won't actually go on the record, it doesn't mean anything is actually clear.

In fact, while the ICCAS document relies heavily on one former Cuban Intelligence official, it insinuates that another former Cuban government official - a former lieutenant colonol in the Cuban Armed Forces who committed Medicare fraud - may himself be proof that the Cuban government is actively involved in the fraud.  That's because of "irregularities" ICCAS notes in the former colonel's case, like he said he was living on the streets in Miami at the time he committed the fraud, but returned to Cuba every year, and even stayed for 8 months at one point.  I guess a conspiracy theorist could surmise he's in cahoots with his not-really-former employer, but couldn't these irregularities also be explained by the fact that the former colonel, like perhaps any common criminal who gets caught, lied to authorities in hopes they'd go easier on him?

I'm in no position to judge whether the hard currency-starved Cuban government is involved in Medicare fraud or not, or whether it's happily harboring U.S. Medicare fraud fugitives and bilking them of their stolen, and presumably, well hidden spoils in exchange, as ICCAS and its single source allege. 

But it does seem like investigators - whether they are in Congress or academia - ought to at least explore some obvious and much more simple possible explanations for the number of Cuban Americans involved in Medicare fraud in South Florida in recent years, before pointing fingers.  As the Miami Herald's Jay Weaver reported several years ago, Medicare fraud is relatively easy to pull off, and rings such as these tend to grow up among ethnic communities elsewhere around the country where trust comes more easily (Weaver cites Armenians in California, West Africans in Houston and Russians in New York).  At the time Weaver wrote his article, nearly half of the Cuban Americans wanted for Medicare fraud were believed to have fled to Cuba.  Is it because they all had connections to the Cuban government?  But if they did, don't we have only ourselves to blame for our own open door immigration policies towards the island?  Maybe they return to Cuba because they still have Cuban passports (to go back for visits, Cuban emigrants must have a valid Cuban passport), and it's cheaper to live in Cuba?  And it could also be because the U.S. and Cuban government don't exactly have a reliable working relationship when it comes to law enforcement matters.

The 1904 U.S.-Cuban extradition treaty, considered essentially defunct now, hasn't been used in decades (and if the U.S. were to try to seek official extradition of fugitives under it, Cuba would surely do the same).  When I explored the subject of increasing law enforcement contacts with Cuba in my Options for Engagement report two years ago, I noted that Cuba had both pledged (according to the U.S. State Department's terrorism report) not to accept more fugitives from the United States, and had, on certain occasions - let's use the term "case by case" - returned fugitives to the U.S.  In the infamous Benitizes case (who defrauded the U.S. government of more than $100 million dollars and fled to Cuba), the FBI admitted it had "not formally asked the Cuban government to turn over the Benitizes . . . because the United States does not have formal relations with Cuba." (See page 11 of the report.) 

So, whether the Cuban government is up to no good or not here, might it not behoove U.S. authorities who want Medicare fraud fugitives returned to open a dialogue with Cuban authorities (and with other countries that fail to return them), as we have in other cases?  Or are we afraid to open that dialogue because we're not ready for it to be a two-way street? 

The ease with which Cuban American Medicare fraud fugitives can flee to Cuba has perplexed and frustrated Florida officials.  The head of Florida's health fraud squad noted of the Cuban Americans (who are admitted as political refugees), "no one thought they were flight risks."  U.S. District Judge, Federico Moreno, wondered whether U.S. policy is enabling the Cuban American fraud and flee phenomenon.

"It seems to me that our thinking has to change -- that someone from Cuba can flee back to Cuba just like someone from Mexico.''

Moreno questioned whether the Cuban Adjustment Act -- passed by Congress in 1966 to grant asylum and residency to the first wave of Cuban political refugees -- was being abused by a new generation of Medicare fraud suspects. The judge wondered aloud ``whether someone can be categorized as a political refugee when you can pick up and go back."