U.S. Attorney General Eric Holder announced that the federal government made what he termed the “largest federal healthcare fraud takedown in our nation’s history.”
The Medicare Fraud Strike Force has charged 111 defendants in nine cities, including doctors, nurses, healthcare 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, according to a U.S. Department of Justice (DOJ) press release. The strike covered nine cities including Miami, Florida; Brooklyn, New York; Houston, Texas; Los Angeles, California; Detroit, Michigan; and Chicago, Illinois.
The enforcement initiative focused on ancillary service providers such as durable medical equipment (DME) companies, home health agencies, and physical/occupational therapy providers. The defendants are accused of various healthcare 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. 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.
The joint DOJ-HHS Medicare Fraud Strike Force is a multi-agency team of federal, state, and local investigators designed to combat Medicare fraud through the use of Medicare data analysis techniques and an increased focus on community policing. More than 700 law enforcement agents from the FBI, HHS-Office of Inspector General (HHS-OIG), multiple Medicaid Fraud Control Units, and other state and local law enforcement agencies participated in the operation. In addition to making arrests, agents executed 16 search warrants across the country in connection with ongoing strike-force investigations.
The Department of Justice (DOJ) and HHS have also announced the expansion of Medicare Fraud Strike Force operations to two additional cities-Dallas and Chicago.
This sweep demonstrates the government’s commitment to enforcement efforts. As part of the health reform law, an additional $95 million was dedicated to fraud enforcement through the federal Fraud and Abuse Control Program in fiscal year 2011.
“With this takedown, we have identified and shut down large-scale fraud schemes operating throughout the country,” Holder said. “We have safeguarded precious taxpayer dollars, and we have helped to protect our nation’s most essential healthcare programs, Medicare and Medicaid. As today’s arrests prove we are waging an aggressive fight against health care fraud.”
