the continued ramping up of Obamacare, enforcement of laws that
prevent Medicare and other health-care fraud will become increasingly
More than 90 individuals were charged on Tuesday in a nationwide
crackdown against what investigators said was massive fraud in
federally administered health-care programs.
The defendants were charged with submitting more than $260 million in
fraudulent claims to the Medicare system. They included 27 medical
professionals, including 16 physicians, who prosecutors say breached
the public trust in pursuit of easy money.
The arrests took place in Miami; Tampa, Fla.; New York; Detroit;
Houston; and Los Angeles.
“The fraud was rampant, it was brazen, and it permeated every part of
the Medicare system,” Acting Assistant Attorney General David O’Neil
said in announcing the enforcement operation.
“The crimes charged represent the face of health care fraud today —
doctors billing for services that were never rendered, supply
companies providing motorized wheelchairs that were never needed,
recruiters paying kickbacks to get Medicare billing numbers of
patients,” O’Neil said in a statement.
The investigation was undertaken by the Justice Department’s Medicare
Strike Force, which since organizing in 2007 has charged 1,900
defendants in cases involving $6 billion in medical services fraud.
The enforcement action was praised by both Attorney General Eric
Holder and Health and Human Services Secretary Kathleen Sebelius.
Holder called the operation “another important step forward in our
ongoing fight to safeguard taxpayer resources and to ensure the
integrity of essential health care programs.”
Secretary Sebelius noted that the Affordable Care Act, the health-care
reform law, grants federal agents greater authority to suspend
Medicare payments when fraud is suspected.
“Today we’re sending a strong, clear message to anyone seeking to
defraud Medicare: You will get caught and you will pay the price,” she
Health-care fraud has long been perceived among criminals as
low-hanging fruit offering millions of dollars in illicit profits with
little chance of being caught. With the continued ramping up of
Obamacare and the influx of ever-greater amounts of federal money into
the health-care system, strict enforcement will become increasingly
Among the six cities featured in the crackdown, Miami had, by far, the
largest group of defendants. Federal agents charged 50 individuals on
Monday and Tuesday for their alleged involvement in false billings
totaling $65 million.
In one $23 million scheme in south Florida, two defendants allegedly
obtained Medicare beneficiary information from a pharmacy owner and
used the information to bill the government for drugs that were never
dispensed. Kickbacks were laundered through shell companies to conceal
the arrangement, prosecutors said.
In Houston, five local physicians are among 11 being prosecuted. The
doctors were charged with conspiring to bill Medicare for home health
services that were unnecessary and sometimes never provided, according
to the government.
Eight individuals were charged in Los Angeles in connection with $32
million in fraudulent billings. The largest fraud was allegedly
undertaken by a doctor who submitted $24 million in false claims,
including for 1,000 motorized wheelchairs.
The seven charged in Detroit allegedly submitted $30 million in false
claims involving home health care, psychotherapy, and infusion
therapy, according to the Justice Department.
In Tampa, seven were charged with billing for services and tests that
were never provided. In one $12 million scheme, the defendants
allegedly used information of Medicare beneficiaries in Miami-Dade
County to bill for services allegedly rendered in Tampa — 280 miles
northwest of Miami.
In Brooklyn, federal prosecutors indicted a local surgeon for billing
the government $85 million for surgeries that never took place. Also
in Brooklyn, six others — including a physician — were charged with
submitting $14.4 million for medically unnecessary vitamin infusions,
diagnostic tests, and physical and occupational therapy.
In addition to charging the alleged fraudsters, federal agents have
also sought to locate and seize illicit assets, including bank
accounts, jewelry, and expensive cars.
— Christian Science Monitor
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