91 People Charged for Fraudulently Billing Medicare $295 Million

91 People Charged for Fraudulently Billing Medicare $295 Million

Have you heard about last week’s arrests in a historic takedown by the Health Care Fraud Prevention and Enforcement Action Team (HEAT) Strike Force? This takedown happened in 8 cities and has resulted in charges against 91 defendants, including doctors, nurses, and other medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $295 million in false billing. This is the highest amount of false Medicare billings in a single takedown in the HEAT Strike Force history.

Read the Department of Health and Human Services’ press release for more info.

Here are some highlights from the release:

  • The schemes involved a variety of services, including: home health care, physical and occupational therapy, mental health services, psychotherapy and durable medical equipment (DME).
  • The fraudulent practices included submitting claims to Medicare for treatments that were medically unnecessary and oftentimes never provided. 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.
  • Locations of those arrested include: Baton Rouge, LA; Brooklyn, NY; Chicago, IL; Dallas, TX; Detroit, MI; Houston, TX; Miami, FL; and Los Angeles, CA.

See our Medicare Fraud section for more info on common fraud schemes, and how to detect, report and prevent it.

Those interested in volunteering to put an end to fraud, check out our Senior Medicare Patrol (SMP) program. We are currently accepting new volunteers.

Our blogger Karen J. Fletcher is CHA's publications consultant. She provides technical expertise, writing and research on Medicare, health disparities and other health care issues. With a Masters in Public Health from UC Berkeley, she serves in health advocacy as a trainer and consultant. See her current articles.