The U.S. Departments of Justice and Health and Human Services fight fraud in the trenches through the Medicare Fraud Strike Force, and the departments recently gave AARP Bulletin a glimpse into force operations in Miami.
"The crackdown has the look of a major narcotics operation," the Bulletin wrote, "complete with electronic surveillance and frequent use of informants and cooperating witnesses."
Agents and prosecutors meet monthly to review fraud cases, the article noted. Investigative teams provide status reports to a supervisory panel from the U.S. Attorney's Office, the DOJ, the FBI and HHS. Pressure to keep cases moving makes the strike force effective, the Bulletin noted.
The hallmark of the strike force approach is using data to speed up investigations and indictments and improve investigative efficiency. As a result, the government is seizing assets, bringing charges against offenders and obtaining convictions with sentences meted out in decades, the Bulletin noted.
Matthew Kolodesh, for example, was sentenced to 176 months in prison after filing $16.2 million in fraudulent claims for home hospice care. And California physician Robert Glazer was charged with healthcare fraud for overprescribing power wheelchairs.
The strike force expanded operations from one office in Miami to nine cities with the support of 40 attorneys from the DOJ. Almost 2,000 people who collectively billed Medicare $6 billion have been charged with crimes since the force's debut in 2007.
This work involves holding beneficiaries' feet to the fire for participating in scams. Grandmother and piano teacher Elsa Capo was indicted for taking kickbacks for allowing her Medicare number to be used in a home healthcare scheme, the Bulletin noted. "Capo, 71, is the new face of Medicare fraud," the magazine wrote. She received three years of probation with 180 days of home confinement.
Overall, "Medicare continues to attract a seemingly endless assortment of swindlers and schemers," the Bulletin wrote, "ex-cons and fugitives, doctors and nurses and ordinary citizens, including immigrants for whom defrauding Medicare has become a new kind of American dream."
Through data analytics, investigative collaboration and operational efficiency, the strike force works to stay ahead of criminals.
- read the AARP Bulletin article