Another 90 Arrests As Strike Force’s Medicare Fraud Tally Hits $6 Billion

McClatchy Washington BureauMay 13, 2014 

In the seventh “takedown” since the government formed a Medicare Fraud Strike Force in 2007, federal agents arrested 90 people on May 13th, including 50 in Miami, on charges they schemed to falsely bill taxpayers $260 million.

In what is becoming an annual affair, the latest figures offer a staggering picture of the extent to which fraudsters are preying on the huge health care program for the nation’s elderly.

Since their inception, Strike Force operations have prosecuted 1,900 people in nine locations on charges that they bilked the government for almost $6 billion. The Department of Health and Human Services’ (HHS) Centers for Medicare & Medicaid Services has removed over 17,000 providers from the Medicare program in the last three years alone.

Why is the Medicare program so vulnerable to fraud? Are there ways to prevent doctors, nurses and others in the health field from scamming taxpayers? Or is the program based so much on an honor system that it’s ripe for the plucking?

These are questions increasingly dogging the program as headlines about new health care fraud arrests and prosecutions seem to stream out of the Justice Department every week.

Attorney General Eric Holder and soon-to-depart HHS Secretary Kathleen Sebelius joined in making the latest announcement, but acting chief David O’Neil of the Justice Department’s Criminal Division appeared with a phalanx of law enforcement officials at a news conference in Miami.

The department said that the multi-agency team of federal, state and local investigators used Medicare data analysis techniques to identify unusual billing patterns and an increased focus on community policing to build evidence against those eventually charged. Undercover officers, wiretaps, hidden cameras and GPS trackers also were used.

“Among the defendants charged today were doctors, home health care providers, doctor’s assistants, pharmacy owners and medical supply company executives,” O’Neill said. “The crimes charged represent the face of health care fraud today – doctors billing for services that were never rendered, supply companies providing motorized wheelchairs that were never needed, recruiters paying kickbacks to get Medicare billing numbers of patients.

“The fraud was rampant, it was brazen andit permeated every part of the Medicare system.”

Nearly 400 federal, state and local law enforcement agents fanned out to make arrests in Miami, Brooklyn, Tampa, Detroit, Houston and Los Angeles.

In Los Angeles, a single doctor was accused of submitting false billings for medically unnecessary home health and medical equipment that cost Medicare $23 million.

“In some of these schemes,” O’Neill said, “we saw doctors going to extravagant lengths to conceal their fraud. In Detroit, we charged a doctor who allegedly conspired with his billing company to conceal his false billings through a complex web of sham partnerships with other health care companies.

“In other schemes, we seized extravagant fruits of the crimes, including bank accounts, jewelry and luxury vehicles tied to the scheme.”

He emphasized the role that patients can play. Many of the charges, he said, stemmed from powerful evidence from Medicare beneficiaries who alerted authorities to Medicare billings using their identification numbers for services they never received.

“Department of Justice will not tolerate these activities,” Holder said. “And we will continue working alongside the Department of Health and Human Services – as well as federal, state and local partners – to use every appropriate tool and available resource to find, stop and punish those who seek to take advantage of their fellow citizens.”

Email: ggordon@mcclatchydc.com; Twitter: @greggordon2.

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