Medicare Fraud Strike Force Nabs 111 in 9 Cities

John Commins, for HealthLeaders Media , February 18, 2011

The 111 people charged on Thursday are accused of various healthcare fraud-related crimes, including conspiracy to defraud Medicare, criminal false claims, violations of the anti-kickback statutes, money laundering and aggravated identity theft. The charges are based on alleged fraud schemes involving various medical treatments and services such as home health care, physical and occupational therapy, nerve conduction tests and durable medical equipment.  

Prosecutors said the defendants participated in schemes to submit claims to Medicare for treatments that were medically unnecessary and often never provided. Indictments and complaints allege that patient recruiters, Medicare beneficiaries and other co-conspirators were paid cash kickbacks to supply beneficiary information to providers, so that the providers could submit fraudulent billing to Medicare. Collectively, the doctors, nurses, healthcare company owners, executives and others are accused of submitting more than $225 million in fraudulent billing, DOJ said.

·        In Miami, 32 defendants, including two doctors and eight nurses, were charged in various fraud schemes involving a total of $55 million in false billings for home health care, durable medical equipment and prescription drugs.

·        In Detroit, 21 defendants, including three doctors, three physical therapists and one occupational therapist, were charged in schemes to defraud Medicare of more than $23 million, in cases involving false claims for home health care, nerve conduction tests, psychotherapy, physical therapy and podiatry.

·        In Brooklyn, NY, 10 people, including three doctors and one physical therapist, were charged with fraud schemes involving $90 million in false billings for physical therapy, proctology services and nerve conduction tests.

·        In Tampa, 10 people were charged in connection with schemes involving more than $5 million related to false claims for physical therapy, durable medical equipment and pharmaceuticals.

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1 comments on "Medicare Fraud Strike Force Nabs 111 in 9 Cities"

David Moskowitz MD FACP (2/19/2011 at 1:58 PM)
$225 million is peanuts compared to the $50 billion a year that Medicare itself has been defrauding the American people since 2006. Medicare could have been saving almost 10% of its budget by preventing 90% of dialysis. That amounts to $50 billion a year now. Turns out too many bureaucrats' salaries are supported by kidney failure to get rid of the disease. Details are at Incidentally, Medicare's Office of the Inspector General didn't consider this to be fraud when I contacted them about it.




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