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Government Charges 91 Individuals with Medicare Fraud for Falsely Billing $430 Million

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The Medicare Fraud Strike Force empowered by the U.S. Department of Justice (DOJ) and the U.S. Department of Health and Human Services (HHS) cast a broad net across seven cities in order to charge 91 people, including doctors, nurses, and other licensed medical professionals, for their alleged participation in Medicare fraud. Their schemes allegedly amounted to $429.2 million in false billing. The HHS-Inspector General’s Office, the DOJ Criminal Division, the Federal Bureau of Investigation (FBI) and the Centers for Medicare and Medicaid Services (CMS) aided in the take down.

Attorney General Eric Holder noted that his department’s enforcement actions revealed an “alarming and unacceptable trend” of people taking advantage of federal health care programs to steal taxpayer dollars for personal gain. Some of the claims submitted to Medicare for treatments were actually medically unnecessary and frequently not provided. Co-conspirators were “paid kickbacks” for providing beneficiary information to providers so fraudulent bills for services never provided could be submitted to Medicare.

According to the joint press release issued by the U.S. Department of Justice and the U.S. Department of Health and Human Services, October 4, defendants are charged with health care fraud-related crimes, including conspiracy to commit health care fraud, health care fraud, violations of the anti-kickback statutes and money laundering. Charges are based on a variety of alleged fraud schemes involving treatments and services, including home health care, mental health services, psychotherapy, physical and occupational therapy, durable medical equipment (DME) and ambulance services.

Cleaning up a lot of this type of Medicare fraud will help to keep Medicare solvent for those of us under 55 – we hope. It is a good start and, hopefully, those continuing to steal from taxpayers will be vigorously pursued.