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Largest Medicare Fraud Sweep Nabs 301 Suspects

News  |  By HealthLeaders Media News  
   June 23, 2016

More than 60 licensed medical professionals were among the suspects arrested in a series of raids across 23 states and charged with fraud in cases totaling more than $900 million in false billing.

Federal officials on Wednesday provided details on a series of sweeping nationwide raids that netted 301 people who allegedly took part in various Medicare and Medicaid schemes involving more than $900 million in false billings.

The operation is the largest in Medicare Fraud Strike Force history, both with respect to the numbers of people arrested and the value of the alleged false billings. The raids involved prosecutors in 36 federal districts and 23 state Medicaid Fraud Control Units.

More than 60 licensed professionals, including physicians and nurses, were swept up in the arrests, the Department of Justice and the Department of the Department of Health and Human Services said in a joint announcement.

"Millions of seniors depend on Medicare for essential health coverage, and our action shows that this administration remains committed to cracking down on individuals who try to defraud the program," HHS Secretary Sylvia Mathews Burwell said in a media statement.

The defendants face healthcare fraud-related crimes, including conspiracy to commit healthcare fraud, violations of the anti-kickback statutes, money laundering, and aggravated identity theft.

The charges are based on a variety of alleged fraud schemes involving various medical treatments and services, including home health care, psychotherapy, physical and occupational therapy, durable medical equipment and prescription drugs. 

More than 60 of the defendants arrested were charged with fraud related to the Medicare Part D prescription drug benefit program, which is the fastest-growing component of Medicare.

"As this takedown should make clear, healthcare fraud is not an abstract violation or benign offense. It is a serious crime," Attorney General Loretta E. Lynch said in a statement released by the department.

"The wrongdoers that we pursue in these operations seek to use public funds for private enrichment. They target real people, many of them in need of significant medical care. They promise effective cures and therapies, but they provide none. Above all, they abuse basic bonds of trust—between doctor and patient; between pharmacist and doctor—between taxpayer and government—and pervert them to their own ends."

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