- The Washington Times - Tuesday, May 14, 2013

Federal law enforcement authorities have arrested 89 people, including doctors and nurses, in eight cities suspected of participating in Medicare fraud schemes involving more than $223 million in false billings.

Attorney General Eric H. Holder Jr. and Health and Human Services Secretary Kathleen Sebelius announced the arrests at a joint press conference. They said the coordinated takedown was the sixth national Medicare fraud operation in the history of the Medicare Fraud Strike Force, which has charged 600 people in schemes involving more than $2 billion in fraudulent billings.

The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Justice Department and HHS to focus their efforts to prevent and deter fraud and enforce anti-fraud laws around the country.

“Today’s announcement marks the latest step forward in our comprehensive efforts to combat fraud and abuse in our health care systems,” said Mr. Holder. “These significant actions build on the remarkable progress that the HEAT has enabled us to make — alongside key federal, state and local partners — in identifying and shutting down fraud schemes.

“They are helping to deter would-be criminals from engaging in fraudulent activities in the first place. And they underscore our ongoing commitment to protecting the American people from all forms of health care fraud, safeguarding taxpayer resources and ensuring the integrity of essential health care programs,” he said.

Ms. Sebelius said the arrests send “a strong, clear message to anyone seeking to defraud Medicare: You will get caught and you will pay the price. We will protect a sacred trust and an earned guarantee.”

The defendants are accused of various health care fraud-related crimes, including conspiracy to commit health care fraud, violations of the anti-kickback statutes and money laundering. The charges are based on a variety of alleged fraud schemes involving various medical treatments and services, primarily home health care, but also mental health services, psychotherapy, physical and occupational therapy, durable medical equipment and ambulance services.

According to court documents, the defendants participated in schemes to submit claims to Medicare for treatments that were medically unnecessary and often never provided. In many cases, the documents say, patient recruiters, Medicare beneficiaries and other co-conspirators were paid cash kickbacks in return for supplying beneficiary information to providers so that the providers then could submit fraudulent billing to Medicare for services that were medically unnecessary or never performed.

Arrests were made in Miami, New Orleans, Houston, Los Angeles, Detroit, Tampa, Fla., Chicago, and Brooklyn, N.Y.



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