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Update: 91 Doctors, Nurses, and Medical Professionals in $430 Million Medicare Fraud – The Biggest Ever

Ninety-one people including doctors, nurses and other medical professionals have been charged with committing $430million in Medicare fraud in seven U.S. cities, authorities said on Thursday.

An investigation coordinated by the U.S. Justice Department and the Department of Health and Human Services uprooted alleged false billing schemes involving $230million in home health services, over $100million in mental health services, and $49million from ambulance transportation.

Charges range from healthcare fraud and conspiracy to wire fraud, kickback violations, identity theft and money laundering.

Attorney General Eric Holder said in a news conference today that the case reveals an alarming trend of criminal attempts to steal billions of taxpayer dollars for personal gain.

‘Today’s enforcement actions reveal an alarming and unacceptable trend of individuals attempting to exploit federal health care programs to steal billions in taxpayer dollars for personal gain,’ he said.

Teamwork: Health and HHS Secretary Kathleen Sebelius, second right, Assistant Attorney General Lanny Breuer, second left, FBI Associate Director Kevin Perkins, right, and HHS Inspector General Daniel Levinson listen

Assistant Attorney Lanny A. Breuer said: ‘Today’s coordinated actions represent one of the largest Medicare fraud takedowns in Department of Justice history.’

He added: ‘We have made it one of the Department’s missions to hold accountable those who abuse the Medicare program for personal profit. 

Medicare Fraud Strike Force operations targeted health care workers in seven cities – Brooklyn, Baton Rouge, Louisiana, Chicago, Dallas, Houston, Los Angeles, and Miami.

In Miami alone, 33 suspects were arrested and charged with fraud of more than $200million, according to NBC Miami

Mr Breuer said in a news conference earlier today that owners and operators at one Miami psychiatric hospital gave cash kickbacks to owners of assisted living facilities in order to obtain more patients.

They then billed the social insurance plan more than $67million, often for services that were never offered, or patients they never actually had. 

Mr Breuer added that these 33 medical professionals then billed Medicare for the cash they used as kickbacks for their false patients. 

Mr Holder condemned the fraud as one that ‘siphon(s) precious taxpayer resources, drive(s) up heath care costs, and jeopardize(s) the strength of the Medicare program.’

He added: ‘They also victimise the most vulnerable members of society, including elderly, disabled, and impoverished Americans.’

According to Mr Holder, one doctor alone was writing 33,000 prescriptions for some 2,000 patients between 2006 and 2011. Dr Joseph Megwa allegedly signed off these documents without reviewing them, causing $103.3million in false billings.

Seven individuals in Houston were charged for giving kickbacks of cigarettes, coupons, and food to Medicare recipients who would in turn just watch TV or play games instead of receiving the services that were billed to Medicare.

It allegedly led to $158million in fraudulent billing.

The announcement marks the latest case in a concerted crackdown against Medicare fraud by an interagency Medicare fraud strike force.

The strike force was created under the healthcare reform law as a means of curbing waste, fraud and abuse within the $590billion Medicare program that provides healthcare benefits to nearly 50million elderly and disabled beneficiaries.

In February of 2011, 111 medical practitioners were charged in a $225million Medicare fraud, which was then the largest of its kind.

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Posted by on October 4, 2012. Filed under NY News,Slider. You can follow any responses to this entry through the RSS 2.0. Both comments and pings are currently closed.