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Feds Nab 91 Suspects in Medicare Billing Schemes Totaling $295M

John Commins, for HealthLeaders Media, September 8, 2011

In Houston, two people were charged with fraud schemes involving $62 million in false billings for home health care and DME. One defendant allegedly sold beneficiary information to 100 different Houston-area home healthcare agencies in exchange for illegal payments. The indictment alleges that the home agencies then used the beneficiary information to bill Medicare for services that were unnecessary or never provided.

In Baton Rouge, LA, 10 people were charged in schemes involving more than $24 million related to false claims for home healthcare and DME. According to one indictment, a doctor, a nurse and five other co-conspirators schemed to bill Medicare for more than $19 million in skilled nursing and other home health services that were medically unnecessary or never provided.

In Detroit, 18 people, including three doctors, were charged last week for schemes to defraud Medicare of more than $28 million. According to an indictment, 14 of the defendants participated in a home healthcare scheme that submitted more than $14 million in false claims to Medicare.

In Brooklyn, three people, including two doctors, were charged for a fraud scheme involving more than $3.4 million in false claims for medically unnecessary physical therapy. 

In Dallas, two people, including a doctor, were charged in a scheme to defraud Medicare of approximately $2.1 million, DOJ said.

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