The Justice Department struck a major blow for Medicare fraud prevention Friday. In coordinated raids, Federal agents introduced no-nonsense health care reform to doctors, nurses, health care company owners and medical billers in five states. Authorities announced charges against 94 people in what is being called the largest coordinated series of federal health care fraud cases in U.S. history. The Medicare fraud defendants are accused of bilking the Medicare system out of more than $251 million.
Medicare fraud sting snares full spectrum of crooks
Federal agents made arrests at alleged Medicare fraud operations in five cities Friday in Miami, Baton Rouge, La., Brooklyn, N.Y., Detroit and Houston. Reporting on the Medicare fraud scheme, ABC News said that the government said doctors, nurses and health care professionals accepted cash kickbacks from medical service providers to approve services that were unnecessary or never delivered. Then the service provider would bill Medicare for the bogus services, including HIV infusions, home health care and physical and occupational therapy.
Medicare fraud crackdown key to health care reform
To battle health care fraud as part of its health care reform agenda, the Obama administration launched the Health Care Fraud Prevention and Enforcement Action Team in 2009. The team uses electronic claims data and the threat of federal prosecution to seek out the illicit billing that has become a staple of Medicare fraud. The arrests came as Attorney General Eric H. Holder Jr. and Health and Human Services Secretary Kathleen Sebelius held the first in a series of regional “summits” on health care fraud prevention in Miami. The massive Medicare fraud raid was a PR opportunity for a concerted crackdown on fraud that is a key part of the administration’s health care reform agenda.
Medicare fraud practiced in plain sight
Some of the Medicare fraud operations uncovered in Friday’s raids were brazen. The Washington Post reports that in one alleged $70 million scheme operated out of a Brooklyn, N.Y., clinic, more than 1,000 cash kickbacks were paid to Medicare beneficiaries out of a “kickback room.” An undercover investigation showed that Medicare beneficiaries lined up to receive illegal payments near a sign showing a woman with her finger to her lips warning in Russian, “Don’t gossip.”
Miami a mecca for Medicare fraud
The Medicare fraud arrests were made by more than 350 agents for the Health and Human Services’ inspector general’s office and the FBI. It was the biggest takedown of Medicare fraud offenders since the federal program was started in 1965. Miami bore the biggest harvest of crooks on the same day the health care fraud summit took place there. The Miami Herald reports that About 25 suspects, including a longtime general practitioner, were charged in Miami-Dade County for allegedly submitting about $103 million in fraudulent bills for home health care, HIV therapy and medical equipment services, according to federal indictments.