111 people charged in nationwide Medicare fraud scheme

2011-02-18 11:40:07 GMT+7 (ICT)

WASHINGTON, D.C. (BNO NEWS) -- In a nationwide Medicare fraud scheme, the U.S. Justice Department (DOJ) on Thursday announced that 111 people were charged in 9 different cities, involving fraudulent schemes worth over $225 million.

According to court documents, the individuals charged participated in schemes to submit claims to Medicare for treatments that were medically unnecessary and oftentimes, never provided. The Medicare Fraud Strike Force charged doctors, nurses, health care company owners and executives, among several others others, for their alleged participation in the Medicare fraud schemes.

In many cases, indictments and complaints allege that patient recruiters, Medicare beneficiaries and other co-conspirators were paid cash kickbacks in return for supplying beneficiary information to providers, so that the providers could submit the fraudulent billing.

In Miami, Florida, 32 people, including 2 doctors and 8 nurses, were charged for their participation in various schemes involving a total of $55 million in false billings for home health care, durable medical equipment and prescription drugs.

Twenty-one defendants, including three doctors, three physical therapists and one occupational therapist, were charged in Detroit for schemes to defraud Medicare of more than $23 million.

Meanwhile, in Brooklyn, New York, 10 individuals, including three doctors and one physical therapist, were charged with fraud schemes involving $90 million in false billings for physical therapy, proctology services and nerve conduction tests, while five people were charged in Los Angeles for their roles in schemes to defraud Medicare of more than $28 million.

Other individuals from Tampa, Florida; Houston and Dallas, Texas; Baton Rouge, Louisiana; and Chicago, Illinois were also charged for participating in fraud schemes worth an estimated total of $31 million.

The charged individuals are accused of various health care fraud-related crimes, including conspiracy to defraud the Medicare program, criminal false claims, violations of the anti-kickback statutes, money laundering and aggravated identity theft.

"With this takedown, we have identified and shut down large-scale fraud schemes operating throughout the country," Attorney General Eric Holder said.

"We have safeguarded precious taxpayer dollars. And we have helped to protect our nation's most essential health care programs, Medicare and Medicaid."

The charges are based on a variety of alleged fraud schemes involving various medical treatments and services such as home health care, physical and occupational therapy, nerve conduction tests and durable medical equipment.

The DOJ teamed with the Health and Human Services Medicare Fraud Strike Force to conduct the investigations using Medicare data analysis techniques and an increased focus on community policing. In addition to making arrests, agents also executed 16 search warrants across the country in connection with ongoing strike force investigations.

-- © BNO News All rights reserved 2011-02-18

The inevitable outcome when the government 'pays' [misnomer, since it is us workers that pay] for a scheme -- people have a much lower threshold when it comes to stealing from the government than a company or a neighbor.