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94 individuals charged in the largest Medicare fraud case in history

16 July 2010 3,210 views No Comment BY: BNO News

MIAMI, FLORIDA (BNO NEWS) – Ninety-four people were charged for their involvement in a $251 million fraud to the U.S. Medicare federal program in four cities prosecutors announced on Friday. This was the largest federal health care fraud in history.

"Here in Miami, 24 defendants have been charged for their alleged involvement in fraud schemes. Additional arrests have been made in Baton Rouge, (Louisiana), Brooklyn, (New York) and Detroit, (Michigan)," said Attorney General Eric Holder.

The operation was conducted by the Medicare Fraud Strike Force, a joint initiative between the Department of Justice and the Department of Health and Human Services (HHS). More than 360 law enforcement agents from the FBI, HHS-Office of Inspector General (HHS-OIG), multiple Medicaid Fraud Control Units, and other state and local law enforcement agencies were part of the operation.

"With today’s arrests, we’re putting would-be criminals on notice: Health care fraud is no longer a safe bet. The federal government is working aggressively – and collaboratively – to pursue health care criminals around the country and to bring these offenders to justice," Holder added.

The charges against the 94 individuals include conspiracy to defraud the Medicare program, criminal false claims, violations of the anti-kickback statutes and money laundering. The charges stemmed from a variety of fraud offenses like physical therapy and occupational therapy schemes, home health care schemes, HIV infusion fraud schemes and durable medical equipment (DME) schemes.

The defendants participated in schemes to submit claims to Medicare for treatments that were unnecessary and in many times never provided. The defendants include doctors, health care company owners, executives and others, which collectively defrauded Medicare for approximately $251 million.

"Although today marks a critical step forward in combating and deterring such illegal activity, our work is far from over. In addition to making arrests around the country, law enforcement agents are executing search warrants in connection with ongoing health care fraud investigations," the Attorney General said.

In Miami, 24 defendants were charged for allegedly participated in many fraud schemes that led to approximately $103 million in false billings. The schemes involved fraudulent billing for HIV infusion services, home health care and physical therapy services.

Twenty-two individuals were charged in Brooklyn for participating in fraud schemed that obtained around $78 million for false billing for physical and occupational therapy and DME. In Baton Rouge, thirty-one defendants were charged for various schemes allegedly involving fraudulent claims for DME totaling approximately $32 million.

Finally in Detroit, eleven people were charged for their involvement in submitting fraudulent claims for home health services, nerve conduction tests and injection and infusion therapy sessions that totaled approximately $35 million. Four defendants were also charged in Houston for their roles in a $3 million fraudulent scheme.

(Copyright 2010 by BNO News B.V. All rights reserved. Info: sales@bnonews.com.)

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