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FBI Charges 53 With Bilking Medicare

Detroit indictments say scammers took in more than $50 million.

 

The FBI announced June 24 it had charged 53 people with Medicare fraud, and U.S. officials vowed a crackdown on scams that cost taxpayers billions.

 

U.S. Attorney General Eric Holder said Medicare fraud charges demonstrate “we will strike back against those fraudulent schemes” that undermine health insurance for the elderly and contribute to rising health costs, Reuters reported.

 

The Justice Department said indictments unsealed in Detroit charged the 53 doctors, business owners, employees, and patients with more than $50 million in Medicare offenses.

 

Healthcare That Wasn’t There

 

Prosecutors charge the suspects submitted bogus claims to Medicare for treatments that were medically unnecessary and in many cases never provided, the Associated Press reported. Some of the beneficiaries accepted cash for signing paperwork claiming they had received medical treatments, authorities said.

 

The Detroit bust followed separate indictments in Miami charging eight people of defrauding the healthcare system by creating phony clinics that produced fraudulent bills of about $100 million, news agencies reported.

 

“We in the FBI now have more than 2,400 pending healthcare fraud investigations,” FBI Director Robert Mueller said.

 

Investigators are using undercover operations and wiretaps in Medicare fraud cases, Mueller said.

 

“By pursuing these methods we can reduce the long-term damage to the American economy and to the citizens we serve,” he said.

 

The indictments signal the White House’s push to combat healthcare fraud.

 

“The Obama Administration is committed to turning up the heat on Medicare fraud and employing all the weapons in the federal government’s arsenal to target those who are defrauding the American taxpayer,” said HHS Secretary Kathleen Sebelius at a press conference to announce the Detroit arrests.

 

Turning Up the HEAT

 

On May 20, Holder and Sebelius announced the cross-departmental Health Care Fraud Prevention and Enforcement Action Team -- or HEAT -- to combat Medicare fraud. HEAT will expand “strike forces” that zero in on “unexplainable billing patterns,” HHS said. The strike forces were established in 2007.

 

A Medicare fraud team in south Florida has convicted 146 defendants and secured $186 million in criminal fines and civil recoveries, HHS said.

 

The team will build on demonstration projects by the HHS inspector general that focus on suppliers of durable medical equipment. The projects increase site visits to potential suppliers to prevent imposters from posing as legitimate DME providers. Initiatives include:

            • Training for providers on Medicare compliance, to help identify and prevent fraud;

            • Improved data sharing between CMS and law enforcement to identify patterns that lead to fraud; and

            • More monitoring of Medicare Parts C (Medicare Advantage plans) and D (prescription drug programs) compliance and enforcement.

Jun 29, 2009, 09:16

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