Attorney General Eric Holder said on Friday that, under the operation of the Medicare Fraud Strike Force, ninety-four people have been charged with participating in schemes to collectively submit more than $251 million in false claims to the Medicare program. The operation is the largest federal health care fraud take-down since the Medicare Fraud Strike Force operations began in 2007.
Of the 94 charged, 24 defendants hail from Miami and include owners of companies, doctors, nurses, and patient recruiters, as well as a medical biller who billed approximately $49 million for fraudulent services. The fraud schemes also involved fraudulent billing for HIV infusion services, home health care and physical therapy services, DME and pharmaceutical medications.
The other defendants are from Baton Rouge, Louisiana; Brooklyn, New York; Detroit; and Houston, Texas.
“Our continued Strike Force operations reflect the unprecedented commitment that inspired the creation of the Health Care Fraud Prevention and Enforcement Action Team in May 2009,” said Attorney General Holder. “With today’s arrests, we’re putting would-be criminals on notice: Health care fraud is no longer a safe bet. The federal government is working aggressively—and collaboratively—to pursue health care criminals around the country and to bring these offenders to justice.”
According to the court documents, the defendants charged today participated in schemes to submit claims to Medicare for treatments that were medically unnecessary and oftentimes, never provided. In many cases, indictments and complaints allege that beneficiaries accepted cash kickbacks in return for allowing providers to submit forms saying they had received the treatments that, in reality, were unnecessary or never provided. Collectively, the doctors, health care company owners, executives and others charged in the indictments and complaints are accused of conspiring to submit more than $251 million in false claims to the Medicare program.
Thirty-one defendants were charged in Baton Rouge for various schemes allegedly involving fraudulent claims for DME totaling approximately $32 million. The defendants include the owners and operators of nine different purported medical services companies and four doctors, 14 patient recruiters, and other individuals who allegedly worked at the medical services companies.
Twenty-two defendants were charged in Brooklyn for their alleged participation in schemes to submit fraudulent claims totaling approximately $78 million. These fraud schemes involved false billing for physical and occupational therapy and DME. The defendants include the owners and operators, patient recruiters and employees at three different purported medical clinics and a medical equipment company, as well as three doctors. According to court documents, six of the defendants charged are serial Medicare beneficiaries, who purported to seek medical treatment from numerous providers, causing the submission of multiple claims to Medicare for purported medical treatments.
In Detroit, 11 defendants were charged for their alleged roles in schemes to submit fraudulent claims to Medicare for home health services, nerve conduction tests, and injection and infusion therapy sessions. The schemes involved a total alleged fraud of approximately $35 million and five different purported medical services companies.
Four defendants were also charged in Houston for their alleged roles in a $3 million scheme to submit fraudulent claims for DME.
In addition to making arrests around the country, law enforcement agents are executing search warrants in connection with ongoing health care fraud investigations.
