Medicare fraud takedown nabs 90 in 6 cities

A Medicare Strike Force enforcement action in six cities resulted in the arrest of 90 people accused of participating in fraud schemes that robbed Medicare of about $260 million, the U.S. Department of Justice announced yesterday.

Charges against the defendants include conspiracy to commit healthcare fraud, violations of anti-kickback statutes and money laundering, the announcement stated. Alleged schemes involved home healthcare, mental health services, psychotherapy, physical and occupational therapy, durable medical equipment and pharmacy fraud.

Those charged included 16 doctors, 11 other licensed medical professionals and healthcare company owners. Authorities also booked an 85 year-old beneficiary who reportedly received kickbacks in return for ordering home healthcare services, Reuters noted.

"They each tried to use the Medicare program as their own personal ATM machine and to line their pockets with our money," U.S. Attorney Wilfredo Ferrer told reporters, according to Reuters.

Doctors allegedly billed for services never rendered. One claimed payment for 1,000 motorized wheelchairs that were either not medically necessary or never delivered, the DOJ noted. Further, recruiters are accused of paying cash kickbacks to get beneficiaries' Medicare identification numbers to use on false claims.

"The fraud was rampant, it was brazen, and it permeated every part of the Medicare system," Acting Assistant Attorney General David A. O'Neil said in the announcement.

As part of the sweep, 50 people were charged in Miami in connection with schemes totaling about $65.5 million for home healthcare, mental health and pharmacy services. These arrests add to mounting evidence that Miami has become a Medicare fraud hotbed. The city is now subject, for example, to a fraud-provoked moratorium imposed by the Centers for Medicare and Medicaid Services on enrollments of new Medicare home healthcare providers.    

Arrests in Tuesday's takedown also occurred in Detroit, Houston, Los Angeles, New York City and Tampa.

This enforcement action was the seventh nationwide sweep in Medicare Fraud Strike Force history, according to the announcement.

For more:
- here's the DOJ announcement
- read the Reuters article