Feds arrest 91 doctors, nurses and others for Medicare fraud

By Charles S. Clark

October 5, 2012

In another tandem operation targeting fraudulent health care billing schemes, the Justice and Health and Human Services departments have arrested 91 doctors, nurses and other medical professionals on charges of fraud totaling $430 million.

The alleged crimes perpetrated in seven cities include more than $230 million in home health care fraud, more than $100 million in mental health care fraud, and about $49 million in ambulance transportation fraud. Charges filed in the previous 24 hours included health care fraud, conspiracy to commit health care fraud, wire fraud, violations of the anti-kickback statutes, aggravated identity theft, and money laundering, Attorney General Eric Holder said at a news conference Thursday attended by HHS Secretary Kathleen Sebelius and other top Justice and HHS officials.

The charges involved “treatments and services that were either medically unnecessary or, in some cases, never actually rendered -- ranging from home health care and mental health services to psychotherapy, physical and occupational therapy, durable medical equipment services, and the largest ambulance fraud scheme ever prosecuted by the Medicare Fraud Strike Force,” Holder said. “Such activities not only siphon precious taxpayer resources, drive up health care costs and jeopardize the strength of the Medicare program -- they also disproportionately victimize the most vulnerable members of society, including elderly, disabled and impoverished Americans.”

The 2010 health care reform law, Sebelius added, “gives us new tools to better fight fraud and make Medicare stronger. In addition to the arrests made today, HHS used new authority from the health care law to stop future payments to many of the health care providers suspected of fraud, saving Medicare resources and taxpayer dollars from being lost to fraud in the first place.”

Since the two departments created the Health Care Fraud Prevention and Enforcement Action Team, known as HEAT, in May 2009, it has helped the government recover more than $10.6 billion in improper payments, Holder said. “Today’s takedown underscores the fact that federal efforts to combat health care fraud have never been more strategic, more comprehensive or more effective.”

He thanked state, local and tribal law enforcement for the coordinated effort, which involved 500 officers overall.

The cities where the alleged schemes took place were Baton Rouge, La.; Brooklyn, N.Y.; Chicago; Dallas; Houston; Los Angeles and Miami.


By Charles S. Clark

October 5, 2012

http://www.govexec.com/oversight/2012/10/feds-arrest-91-doctors-nurses-and-others-medicare-fraud/58624/