Feds Charge 94 Suspects in Five-city Medicare Fraud Sweep

Ninety-four people in five cities—including more than seven physicians—have been charged in alleged schemes to submit $251 million in Medicare false claims, U.S. Attorney General Eric Holder announced Friday.

The joint Medicare Fraud Strike Force operation involved 360 law enforcement officials from the FBI, HHS-Office of Inspector General, and other state and local agencies, who made 36 arrests in Miami; Baton Rouge, LA; Brooklyn, NY; Detroit; and Houston. More arrests are expected today and through the weekend as other warrants are executed.

"With today's arrests, we're putting would-be criminals on notice: Healthcare fraud is no longer a safe bet," Holder said in a media release. "The federal government is working aggressively—and collaboratively—to pursue healthcare criminals around the country and to bring these offenders to justice."

Charges unsealed today against the 94 defendants who are accused of various fraud-related offenses, include conspiracy to defraud Medicare, criminal false claims, violations of the anti-kickback laws, and money laundering.

The charges are based on a variety of fraud schemes involving physical therapy and occupational therapy, home healthcare, HIV infusion, and durable medical equipment.

The defendants charged today allegedly submitted false claims to Medicare for treatments that were medically unnecessary and oftentimes, never provided. In many cases, complaints allege that Medicare beneficiaries accepted cash kickbacks in return for allowing providers to submit forms saying they had received the non-existent or unneeded treatments that were collectively valued at more than $251 million.

• In Miami, 24 people were charged for allegedly participating in schemes that led to $103 million in false billings. The defendants include owners 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 Baton Rouge, 31 people were charged in schemes involving fraudulent claims for DME totaling approximately $32 million. The defendants include the owners of nine different purported medical services companies, four doctors, 14 patient recruiters and others.
• In Brooklyn, 22 people were charged with filing fraudulent claims totaling $78 million. These schemes involved false billing for physical and occupational therapy and DME. The defendants include the owners, patient recruiters and employees at three different medical clinics and a medical equipment company, and three doctors. Six defendants are Medicare beneficiaries, who allegedly sought treatment from numerous providers, causing the submission of multiple claims to Medicare.
• In Detroit, 11 people at five medical services companies were charged in schemes to submit fraudulent $35 million in bogus claims for home health services, nerve conduction tests and injection and infusion therapy sessions.
• Four defendants were charged in Houston for their alleged roles in a $3 million scheme to submit fraudulent claims for DME.

  In addition to the arrests, law enforcement agents are executing search warrants for ongoing healthcare fraud investigations.

  Since its inception in March 2007, the Strike Force has obtained indictments of more than 810 people and organizations that collectively have billed Medicare for more than $1.85 billion.