Medicare Fraud Strike Force discovers 251 million dollars alleged false billing
Ninety-four people were charged for their alleged participation in schemes to provide more than $251 million in false claims to the Medicare program including conspiracy to defraud the Medicare program, criminal false claims, violations of the anti-kickback statutes and money laundering.
The joint DOJ-HHS Medicare Fraud Strike Force is designed to combat Medicare fraud through the use of Medicare data analysis techniques and an increased focus on community policing. They are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS in order to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.
According to the documents of the court, the defendants charged on the 16th of July 2010 participated in schemes to submit claims to Medicare for treatments that were medically unnecessary and most of the time was never provided.
For instance, 24 defendants were charged in Miami for their alleged participation in various fraud schemes that led to approximately $103 million in false billings. The type of defendants included owners and operators of companies, doctors, nurses, and patient recruiters, as well as a medical biller who is alleged to have billed approximately $49 million for fraudulent services.
In Brooklyn, twenty-two defendants were charged for allegedly taking part in schemes to submit fraudulent claims totaling approximately $78 million. These fraud schemes concerned 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.
Lastly, 11 defendants, in Detroit, 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.
However, an indictment is merely an allegation, and defendants are presumed innocent until and unless proven guilty.
For more information on the HEAT team, go to: www.stopmedicarefraud.gov.