243 individuals —- including medical professional such as doctors, nurses, and others–were arrested for their alleged involvement in Medicare fraud schemes totalling approximately $712 million in false billings.
The arrests were a coordinated operation in 17 cities by Medicare Fraud Strike Force teams, which include personnel from the FBI, the Department of Health and Human Services (HHS), the Department of Justice (DOJ), and local law enforcement.
The arrests are the largest-ever health care fraud takedown in terms of both loss amount and arrests.
The charges are based on a variety of alleged fraud schemes involving medical treatments and services. According to court documents, the schemes included submitting claims to Medicare for treatments that were medically unnecessary and often not provided. In many of the cases, Medicare beneficiaries and other co-conspirators were allegedly paid cash kickbacks for supplying beneficiary information so providers could submit fraudulent bills to Medicare. Forty-four of the defendants were charged in schemes related to Medicare Part D, the prescription drug benefit program, which is the fastest growing component of Medicare and a growing target for criminals.
Some highlights of the cases:
In Miami, 73 were charged in schemes involving about $263 million in false billings for pharmacy, home health care, and mental health services.
In Houston and McAllen, 22 were charged in cases involving more than $38 million. In one case, the defendant coached beneficiaries on what to tell doctors to make them appear eligible for Medicare services and then received payment for those who qualified. The defendant was paid more than $4 million in fraudulent claims.
Visit the The Strike Force’s webpage for more releases.