Medicare Fraud Crackdown Nabs 91 Doctors, Nurses, and Others


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Last week U.S. Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius announced that a Medicare Fraud Strike Force operation has led to charges against 91 people in seven cities across the U.S. According to the HHS, those charged include doctors, nurses, and "other licensed medical professionals.

“Today’s enforcement actions reveal an alarming and unacceptable trend of individuals attempting to exploit federal health care programs to steal billions in taxpayer dollars for personal gain,” said Holder. “Such activities not only siphon precious taxpayer resources, drive up health care costs, and jeopardize the strength of the Medicare program – they also disproportionately victimize the most vulnerable members of society, including elderly, disabled and impoverished Americans.”

As indictments were unsealed, "dozens" of those charged were arrested or surrendered. They are accused of participating in Medicare fraud that totals $429.2 million in false billing. The fraud includes $230 million in home health care fraud, over $100 million in mental health care fraud, and over $49 million in ambulance transportation fraud. The charges are for health care fraud and fraud-related crimes such as conspiracy to commit health care fraud, money laundering, and "violations of the anti-kickback statutes."

The HHS also suspended payment to or "took other administrative action" against 30 health care providers following what it states are credible allegations of fraud and a data-driven analysis.

“Today’s arrests put criminals on notice that we are cracking down hard on people who want to steal from Medicare,” said Sebelius. “The health care law gives us new tools to better fight fraud and make Medicare stronger. In addition to the arrests made today, HHS used new authority from the health care law to stop future payments to many of the health care providers suspected of fraud, saving Medicare resources and taxpayer dollars from being lost to fraud in the first place.”