Medicare Fraud Strike Force Nabs 111 in 9 Cities

At least eight physicians, eight nurses, four physical therapists, and several healthcare company owners and executives were among the 111 people in nine cities who were charged Thursday in separate Medicare fraud investigations that federal investigators say were responsible for at least $225 million in false billings.

More than 700 law enforcement officials executed 16 search warrants in the round ups – the largest one-day sweep of its kind. Led by the federal Medicare Fraud Strike Force, law enforcement officials made arrests in Miami, Brooklyn, Houston, Los Angeles, Baton Rouge, Tampa, Detroit, Dallas, and Chicago, the Department of Justice and Health and Human Services said in a joint announcement.

"With this takedown, we have identified and shut down large-scale fraud schemes operating throughout the country, we have safeguarded precious taxpayer dollars, and we have helped to protect our nation's most essential healthcare programs, Medicare and Medicaid," Attorney General Eric Holder said at a news conference Thursday afternoon announcing the sweep.

Also Thursday, DOJ and HHS announced the expansion of the Medicare Fraud Strike Force to Dallas and Chicago.

"Over the last two years our joint efforts have more than quadrupled the number of anti-fraud Strike Force teams operating in fraud hot spots around the country from two to nine -- with the latest additions Chicago and Dallas -- bringing hundreds of charges against criminals who had billed Medicare for hundreds of millions of dollars," HHS Secretary Kathleen Sebelius said. "Last year alone, our partnership recovered a record $4 billion on behalf of taxpayers.  From 2008-2010, every dollar the Federal Government spent under its Health Care Fraud and Abuse Control programs averaged a return on investment of $6.80."

The 111 people charged on Thursday are accused of various healthcare fraud-related crimes, including conspiracy to defraud Medicare, criminal false claims, violations of the anti-kickback statutes, money laundering and aggravated identity theft. The charges are based on alleged fraud schemes involving various medical treatments and services such as home health care, physical and occupational therapy, nerve conduction tests and durable medical equipment.  

Prosecutors said the defendants participated in schemes to submit claims to Medicare for treatments that were medically unnecessary and often never provided. Indictments and complaints allege that patient recruiters, Medicare beneficiaries and other co-conspirators were paid cash kickbacks to supply beneficiary information to providers, so that the providers could submit fraudulent billing to Medicare. Collectively, the doctors, nurses, healthcare company owners, executives and others are accused of submitting more than $225 million in fraudulent billing, DOJ said.

·        In Miami, 32 defendants, including two doctors and eight nurses, were charged in various fraud schemes involving a total of $55 million in false billings for home health care, durable medical equipment and prescription drugs.

·        In Detroit, 21 defendants, including three doctors, three physical therapists and one occupational therapist, were charged in schemes to defraud Medicare of more than $23 million, in cases involving false claims for home health care, nerve conduction tests, psychotherapy, physical therapy and podiatry.

·        In Brooklyn, NY, 10 people, including three doctors and one physical therapist, were charged with fraud schemes involving $90 million in false billings for physical therapy, proctology services and nerve conduction tests.

·        In Tampa, 10 people were charged in connection with schemes involving more than $5 million related to false claims for physical therapy, durable medical equipment and pharmaceuticals.

·        In Houston, nine people were charged in schemes involving $8 million in fraudulent Medicare claims for physical therapy, durable medical equipment, home health care and chiropractor services.

·        In Dallas, seven people were indicted for conspiring to submit $2.8 million in false billing to Medicare related to durable medical equipment and home healthcare.

·        In Los Angeles, five people were charged in schemes to defraud Medicare of more than $28 million, involving false claims for durable medical equipment and home health care.

·        In Baton Rouge, six people were charged for a durable medical equipment fraud scheme involving more than $9 million in false claims.

·        In Chicago, charges were filed against 11 people in businesses that have billed Medicare more than $6 million for home health, diagnostic testing and prescription drugs.

Since their inception in March 2007, Strike Force operations in nine districts have charged more than 990 people who collectively have falsely billed Medicare for more than $2.3 billion.