Ninety Individuals Charged in Approx $260 Million Medicare Fraud

The US Department of Justice announced on Tuesday, May 13, that the Medicare Fraud Strike Force had charged 90 individuals, including 27 doctors, nurses and other medical professionals for their alleged part in Medicare fraud schemes involving approximately $260 million in false billings. The accused were apprehended from across six cities. Attorney General Eric Holder and HHS Secretary Kathleen Sebelius made the announcement.

The DOJ announced that this is the seventh coordinated national takedown of the Medicare Fraud Strike Force. The MFSF works as part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative created in 2009 between the Department of Justice and the Department of Health and Human Services.

The defendants are accused of various health care fraud-related crimes including conspiracy to commit health care fraud, money laundering and violations of the anti-kickback statutes. The defendants had participated in a variety of alleged fraud schemes involving medical treatments and services, including mental health services, physical and occupational therapy, pharmacy fraud, home health care, psychotherapy and fraud in durable medical equipment.

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According to court records the defendants participated in schemes to submit claims to Medicare for unnecessary treatments that were often never provided. In a large number of cases, patient recruiters as well as Medicare beneficiaries received kickbacks, as did other co-conspirators.

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Speaking on the successful strike, Acting Assistant Attorney General O'Neil said, "Today, across the nation, scores of defendants were arrested for engaging in hundreds of millions of dollars in health care fraud … Among the defendants charged were 27 medical professionals, including 16 doctors. The crimes charged represent the face of health care fraud today - doctors billing for services that were never rendered, supply companies providing motorized wheelchairs that were never needed, recruiters paying kickbacks to get Medicare billing numbers of patients."

Defendants are presumed innocent until proven guilty.

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