I work in the healthcare insurance biz.
Rampant fraud.
I have clients, especially seniors who say they were in Florida all winter and their provider back home billed Medicare for an office visit or lab in say January.
99% are not paying for the service anyway and won’t turn in their doc who they like and afraid of loosing.
I lived in South Florida back in the 90’s. Retirees would call an ambulance for a cold because it cost them less than if they walked into the ER.