A nationwide investigation by the federal Medicare Fraud Strike Force has led to health fraud charges against 243 people – including 46 medical providers – in the largest bust in strike force history.
The defendants are accused of various Medicare fraud schemes that involved $712 million in false billings to the Centers for Medicare & Medicaid Services, according to a joint announcement on June 18 by Health and Human Services Secretary Sylvia M. Burwell and Attorney General Loretta E. Lynch.
Among the allegations are that defendants submitted claims to Medicare and Medicaid for treatments that were medically unnecessary and often never provided. In many cases, patient recruiters, Medicare beneficiaries, and other coconspirators were allegedly paid cash kickbacks in return for supplying beneficiary information to providers so that physicians then could bill Medicare fraudulently, according to the announcement. The defendants include doctors, nurses, and other licensed professionals, along with lay individuals who participated in the alleged fraud. Several health professionals were also suspended from participating in federal government health care programs.
Accused defendants are from Los Angeles; Dallas, McAllen, and Houston, Tex.; Detroit; Brooklyn, N.Y.; Tampa and Miami; and New Orleans. Among the medical services involved in the alleged schemes are home health care, mental health services, pharmacy services, durable medical equipment, and physical and occupational therapy.
The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative between the Department of Justice and HHS to prevent and deter fraud and enforce antifraud laws. Since its inception in March 2007, Strike Force operations in nine locations have charged more than 2,300 defendants for allegedly falsely billing more than $7 billion to the Medicare program.
