Medicare fraud was hit hard Friday by the Justice Department. The feds planned out raids which were to show no-nonsense health care reform to all nurses, doctors, medical billers, and health care business owners in five different states involved. Authorities announced charges against 94 individuals in what is being called the largest coordinated series of federal health care fraud cases in U.S. history. The defendants of the fraud case were accused of stealing $ 251 million from the Medicare system.
Many different individuals involved in Medicare fraud
Because of the Medicare fraud, the feds arrested individuals in Baton Rouge, LA, Brooklyn, NY, Detroit, Houston, and Miami. For services never executed, health care professionals of all kinds accepted money for services that they never really did. These services, HIV infusions, home health care, and physical and occupational therapy, would be charged to Medicare although they never happened.
Health care reform calls for that Medicare fraud stop
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. Illicit billing, which is the main way fraud happens, is found by the team using electronic claims data. Health care fraud prevention had the first “summit” in Miami with Eric H Holder Jr., Attorney General, and Kathleen Sebelius, Human Services Secretary. 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 not hidden
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 for Medicare fraud
350 agents in the Health and human Services’ inspector general’s office and FBI made the arrests. It was the biggest takedown of Medicare fraud offenders since the federal program was began 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.
Discover more details
ABC News
abcnews.go.com/WN/government-agents-uncover-medicare-fraud-operations-cities/story?id=11180320&page=2
Washington Post
washingtonpost.com/wp-dyn/content/article/2010/07/16/AR2010071603876.html?hpid=topnews
Miami Herald
miamiherald.com/2010/07/16/1733354/crackdown-nets-about-100-medicare.html
