Fifty-three physicians, healthcare executives, and Medicare beneficiaries were arrested Wednesday in New York City, Miami, and Detroit by the newly expanded federal Medicare Fraud Strike Force. They were charged with submitting more than $50 million in Medicare claims related to unnecessary or fraudulent procedures.
In a joint press conference in Washington, Attorney General Eric Holder, Department of Health and Human Services Secretary Kathleen Sebelius, and FBI Director Robert Mueller announced the indictments and arrests by the strike force operations in Detroit, which are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT). HEAT is a renewed joint effort announced last month between the Justice Department and HHS that focuses on enforcement of current anti fraud laws around the country. Programs had been underway earlier in Los Angeles and Miami.
The charges that were unsealed Wednesday were made against 53 individuals accused of various Medicare fraud offenses, including conspiracy to defraud the Medicare program, criminal false claims, and violation of anti kickback statutes.
Federal agents from the FBI and the HHS Office of Inspector General began executing arrest warrants in Detroit, Miami, and New York City as part of an effort to address fraud in the metro Detroit area. The strike force operations in Detroit identified two primary areas--infusion therapy and physical/occupational therapy providers--in which schemes were allegedly organized to defraud Medicare.
According to the indictments, the defendants were charged with submitting claims to Medicare for treatments that were considered medically unnecessary--and many times never provided. The indictments allege that beneficiaries also accepted cash kickbacks in return for allowing providers to submit forms saying they had received the unnecessary--and not provided--treatments. Those indicted included physicians, medical assistants, patients, company owners, and executives.
"As demonstrated by today's charges and arrests, we will strike back against those whose fraudulent schemes not only undermine a program upon which 45 million aged and disabled Americans depend, but which also contribute directly to rising health care costs," said Holder in a statement.
Most physicians, patients, and medical companies "do the right thing and work with the Medicare program to provide access to medical services," he said. "To those who work diligently and ethically to provide medical care through the Medicare program, we will work with you to root out the few who corrupt the system and taint the good reputations of health professionals everywhere."