Federal officials recently indicted 53 people for fraud schemes to cheat Medicare out of $50 million. Suspects were arrested in Detroit, Miami, and Denver as part of a wide-ranging effort by the government to crack down on fraud. Attorney General Eric Holder, Department of Health and Human Services (HHS) Secretary Kathleen Sebelius and FBI Director Robert Mueller announced the charges at a news conference. “Today’s landmark series of arrests in Detroit and across the country demonstrates that health care fraud can happen anywhere in America,” said Daniel R. Levinson, Inspector General of the Department of Health & Human Services. “We will continue to detect and respond rapidly to emerging fraud schemes to protect our federal health care programs and conserve scarce health care dollars so critically needed for the care of our beneficiaries.”
The indictments come as the Obama administration is aggressively pushing Medicare fraud prevention along with criminal prosecutions as the President seeks to expand healthcare coverage for millions of uninsured Americans, according to the Miami Herald. Meanwhile, Medicare’s eroding financial stability increases the pressure on authorities to crack down on fraud.
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According to the recent health care fraud indictments in Detroit, Miami, and Denver, the defendants charged participated in schemes to submit claims to Medicare for treatments that were medically unnecessary or never provided. In many cases, the indictments also allege that beneficiaries accepted cash kickbacks in return for allowing providers to submit forms saying they had received the unnecessary and not provided treatments. Collectively, the physicians, medical assistants, patients, company owners and executives charged in the indictments are accused of conspiring to submit more than $50 million in false claims to the Medicare program.
Federal officials used the indictments to highlight the work of the Health Care Fraud Prevention and Enforcement Action Team (HEAT) - a renewed effort announced in May between the DOJ and HHS to prevent fraud and enforce current anti-fraud laws around the country. Co-chaired by Deputy Attorney General David Ogden and Deputy Secretary Bill Corr, the HEAT taskforce is comprised of top-level law enforcement agents, prosecutors and staff from both Departments and their operating divisions.
In a statement, FBI Director, Robert S. Mueller, said, “Health care fraud impacts all Americans—not only in terms of taxpayer losses, but in terms of the integrity of our health care system and our collective safety.” According to Mueller, the FBI has obtained 408 convictions and recovered more than $643 million this fiscal year alone. He adds there are also more than 2,400 pending health care fraud investigations. Mueller also notes the FBI has task forces and working groups to address health care fraud in each of the FBI’s 56 field offices, and the FBI is shifting resources to fraud hot spots. “We are using intelligence across the board to predict, prevent, and ultimately prosecute health care fraud wherever we see fit,” he said.