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
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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.