Medicare Fraud of $251 Million, 94 Suspects Indicted

Jul 26, 2010   

On Friday, July 16, the Department of Justice (DOJ) and Department of Health and Human Services (HHS) announced that the joint DOJ-HHS Medicare Fraud Strike Force has charged 94 people for alleged participation in Medicare schemes.  The suspects, collectively, submitted more than $251 million in false claims to the Medicare program. 

More than 360 law enforcement agents from federal and state agencies participated in the operation.  According to the DOJ and HHS, the operation is the largest federal health care fraud takedown since the inception of the Strike Force in 2007.  Last Friday, 36 of the 94 individuals were arrested in Miami, New York, Baton Rouge, and Detroit.  The individuals charged are doctors, nurses, health care company owners, and executives.

The 94 individuals involved in this takedown have been accused of various Medicare fraud-related offenses, including conspiracy to defraud the Medicare program, criminal false claims, violations of the anti-kickback statutes and money laundering.  The alleged schemes involve physical and occupational therapy schemes, home health care schemes, HIV infusion fraud schemes, and durable medical equipment (DME) schemes. 

In Miami, 25 defendants have been charged for allegedly participating in fraud schemes leading to approximately $103 million in false billings.  The defendants include a medical biller who allegedly billed approximately $49 million for fraudulent services. 

The Strike Force in Miami, and other cities across the country, is part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT).  HEAT is part of the joint DOJ-HHS initiative to fight fraud and enforce anti-fraud laws around the country.  Phase 1 of the initiative began in South Florida in March 2007 and has expanded north to Tampa, Florida.  Since March 2007 the Strike Force has obtained indictments of more than 810 individuals and organizations that have billed the Medicare program, collectively, for more than $1.85 billion.

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