$225 Million Medicare Fraud 111 Charged
The Medicare Fraud Strike Force today charged 111 defendants in nine cities, including Los Angeles, Miami, Brooklyn, Baton Rouge, Houston, Detroit and Tampa. In the raid involved more than 700 law enforcement officers, including the FBI. Among those arrested including doctors, nurses, health care company owners and executives, and others, for their alleged participation in Medicare fraud schemes involving more than $225 million in false billing, announced Attorney General Eric Holder, Health and Human Services (HHS) Secretary Kathleen Sebelius, FBI Executive Assistant Director Shawn Henry, Assistant Attorney General Lanny A. Breuer of the Criminal Division and HHS Inspector General Daniel Levinson. Also today, the Department of Justice (DOJ) and HHS announced the expansion of Medicare Fraud Strike Force operations to two additional cities – Dallas and Chicago. Today’s operation is the largest-ever federal health care fraud takedown.
The defendants charged today are accused of various health care fraud-related crimes, including conspiracy to defraud the Medicare program, criminal false claims, 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 such as home health care, physical and occupational therapy, nerve conduction tests and durable medical equipment.
According to court documents, the defendants charged today participated in schemes to submit claims to Medicare for treatments that were medically unnecessary and oftentimes, never provided. In many cases, indictments and complaints allege that patient recruiters, Medicare beneficiaries and other co-conspirators were paid cash kickbacks in return for supplying beneficiary information to providers, so that the providers could submit fraudulent billing to Medicare for services that were medically unnecessary or never provided. Collectively, the doctors, nurses, health care company owners, executives and others charged in the indictments and complaints are accused of conspiring to submit a total of more than $225 million in fraudulent billing.
A podiatrist performing partial toenail removals was among 21 indicted in Detroit. Dr. Errol Sherman is accused of billing Medicare about $700,000 for the costly and unnecessary procedures, which authorities said amounted to little more than toenail clippings. The podiatrist billed Medicare for 20 nail removals on three toes of one patient, according to the indictment. He charged Medicare about $110 for each procedure.
A Brooklyn, N.Y., proctologist was charged with billing $6.5 million for hemorrhoid removals, most of which he never performed. Dr. Boris Sachakov claimed he performed 10 hemorrhoid removals on one patient, which authorities said is not possible.
Sachakov had been arrested last year on charges related to a separate scam. Sachokov denied the charges.
Authorities also busted three physical therapy clinics in Brooklyn, run by an organized network of Russian immigrants accused of paying recruiters to find elderly patients so they could bill for nearly $57 million in physical therapy that amounted to little more than back rubs, according to the indictment.
In Miami, two doctors and several nurses from ABC Home Health Care Inc. were charged with swindling $25 million by writing fake prescriptions recommending nurses and other expensive aids to treat homeboundpatients, authorities said. The services were never provided.
In total, nearly three dozen defendants were charged in Miami in various scams that topped about $56 million.
Top FBI official, Shawn Henry, said 2,600 health care fraud cases were under investigation and that organised crime groups have been increasingly linked to the alleged schemes.
Fraud has accounted for as much as $60billion a year in the Medicare programme.
Ms Sebelius said $4billion was recovered last year, and the government’s Medicare Fraud Strike Force was recently expanded to nine cities, with the addition of Dallas and Chicago.