Medicare anti-fraud effort leads to record arrests

More than 90 people, including physicians, are charged with fraudulent activity involving more than $251 million in false claims to Medicare.

By Chris Silva — Posted July 27, 2010

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

Strike force teams committed to weeding out Medicare fraud announced July 16 that they were indicting more than 90 people for their alleged participation in schemes to submit more than $251 million collectively in false Medicare claims.

The operation represents the largest federal takedown since Medicare fraud strike force operations began in 2007, federal officials said in a statement. The arrests were made in Baton Rouge, La.; Brooklyn, N.Y.; Detroit; Houston; and Miami. Those metropolitan areas now host strike force operations as part of the Health Care Fraud Prevention and Enforcement Action Team, or HEAT -- a joint initiative between the Depts. of Justice and Health and Human Services since 2009.

The individuals, who include physicians, nurses and beneficiaries, are accused of various Medicare fraud offenses, including violations of anti-kickback statutes and money-laundering laws. The charges are based on illegal claims for a variety of health care services, including physical and occupational therapy, home health care, HIV infusion and durable medical equipment.

According to court documents, the defendants conspired to charge Medicare for treatments that were either medically unnecessary or were never provided.

In Miami, 24 individuals were charged with fraud that led to approximately $103 million in false billings. Thirty-one people were charged in Baton Rouge for fraudulent DME claims totaling about $32 million. Twenty-two individuals were charged in Brooklyn for fraud totaling $78 million. In Detroit, 11 defendants were charged for fraud totaling $35 million. And in Houston, four individuals were charged for taking part in a $3 million fraud scheme.

Back to top




Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story

Read story


American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story

Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story

Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story

Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story

Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story

Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story

Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn