On Feb. 17, federal law enforcement announced charges against 111 defendants in nine states for their alleged participation in a fraud scheme that involved approximately $225 million in Medicare billing. Those arrested include doctors, nurses, pharmacists, physical therapists and other health care professionals. According to officials, this is the largest-ever federal healthcare fraud takedown.
"With today's arrests, we're sending an important message: health care fraud is not easy money," said Attorney General Eric Holder. "It is a serious crime-and, as we've shown today, we will make sure it has serious consequences."
"Every American bears the burden of health care fraud, and the FBI, in conjunction with our inter-agency partners, will continue to dismantle criminal networks that bilk the system," said Shawn Henry, executive assistant director of the Federal Bureau of Investigation's (FBI) Criminal, Cyber, Response, and Services Branch.
More than 700 law enforcement personnel made the arrests in Miami, Fla.; Tampa, Fla.; Brooklyn, N.Y.; Houston, Texas; Dallas, Texas; Baton Rouge, La.; Los Angeles, Calif.; Detroit, Mich.; and Chicago, Ill. Those making the arrests include personnel from the FBI and Health and Human Services (HHS) Office of Inspector General, multiple Medicaid fraud control units, and other state and local law enforcement agencies. The takedown was a result of the Department of Justice/HHS Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative and its Medicare Fraud Strike Force.
According to court documents, the defendants allegedly participated in schemes to submit claims to Medicare for medically unnecessary treatments and treatments that were never provided. One example was a proctologist in Brooklyn, who received $4.4 million from Medicare and $5.8 million from private benefit programs through false billings for examinations and surgical procedures. Other cases include providers offering kickbacks to Medicare beneficiaries to convince them to allow the company to bill Medicare under their names.
Since the task force began in March 2007, approximately 990 individuals have been charged for false billing schemes and over 750 people have been convicted. The illegal schemes total more than $2.3 billion and last year the task force recovered $4 billion in fines and other restitution payments.