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Largest Fed Health Care Fraud Arrest Takes Place


The Capitol

94 people have been charged with submitting, in total, $251 million worth of false claims to Medicare. The Medicare Fraud Strike Force in Miami, FL; Baton Rouge, LA; Brooklyn, NY; Detroit, MI; and Houston, TX rounded-up the 94 people within the 5 cities. The Force is a combined effort between the Department of Justice (DOJ) and Health and Human Services (HHS) and is a “multi-agency team of federal, state and local investigators designed to combat Medicare fraud through the use of Medicare data analysis techniques and an increased focus on community policing. 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” are involved in the Medicare Fraud Strike Force. This is the largest federal health care fraud arrest since the beginning of the Force.

The 94 people charged (consisting of doctors, nurses, health care company owners and executives) are accused of conspiracy to defraud Medicare, violating anti-kickback laws, money laundering, and submitting criminal false claims. Many submitted claims for treatments that were not necessary or were never provided. According to Secretary Sebelius, under the Affordable Care Act, those defrauding Medicare will be subject to stricter penalties.

In addition to the arrests, search warrants are also being issued.

‘Our continued Strike Force operations reflect the unprecedented commitment that inspired the creation of the Health Care Fraud Prevention and Enforcement Action Team [HEAT] in May 2009,’ said Attorney General Holder. ‘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.’” HEAT, another DOJ and HHS collaborative program, aims to both reduce fraud and enforce anti-fraud laws. According to Daniel R. Levinson, the Inspector General of HHS, HEAT provides a “‘swift, agile, and organized’” method to combating fraud.

The United States Department of Justice, Office of Public Affairs. “Medicare Fraud Strike Force Charges 94 Doctors, Health Care Company Owners, Executives and Others for More Than $251 Million in Alleged False Billing.”



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