Scores Charged In $295 Million Rash Of Medicare Fraud Schemes

Ninety-one suspects, including doctors and nurses, have been charged in connection with a new rash of healthcare fraud schemes aimed at bilking the government out of about $295 million, U.S. authorities said Wednesday.

Attorney General Eric Holder, Health and Human Services Secretary Kathleen Sebelius and FBI Executive Assistant Director Shawn Henry announced the charges in Washington, saying they resulted from strikes targeting crime rings in eight U.S. cities that preyed on Medicare, the federal health insurance plan for the elderly and disabled.

"From Brooklyn to Miami to Los Angeles, the defendants allegedly treated the Medicare program like a personal piggy bank," the head of the Justice Department's criminal division, Lanny Breuer, told reporters in Washington.

The anti-fraud sweep over the last two weeks involved some 400 law enforcement agents from the FBI, HHS-Office of the Inspector General, multiple Medicaid Fraud Control Units, and other state and local law enforcement agencies.

Officials said the operations took place in Miami, Houston, Baton Rouge, Los Angeles, Detroit, Dallas, New York and Chicago.

Around half of the defendants were charged in Miami, the southeastern city widely viewed by law enforcement experts as the healthcare fraud capital of the United States.

The Miami defendants alone were accused of participation in fraud schemes involving a total of nearly $160 million in false billings for home and mental health services, occupational and physical therapy, HIV infusion, and other services.

"South Florida remains ground zero for healthcare fraud," John V. Gillies, special agent in charge of the FBI's Miami division, told reporters in Miami.

According to court documents, the defendants allegedly participated in schemes to submit claims to Medicare for treatments that were medically unnecessary and often never provided.

Gillies said 42 suspects had been arrested on Tuesday and Wednesday in the Miami area, where authorities were still looking for three fugitives.

Despite what he and others touted as the success of the latest crackdown on healthcare fraud, Gillies said he saw no end to the Medicare fraud problem any time soon.

"We have dozens and dozens of cases to go," said Gillies, referring to a fraud that the FBI has estimated to cost U.S. taxpayers anywhere between $70 billion and $234 billion a year.

"I don't have all the resources I need. I don't believe the IG's Office (Office of Inspector General) has all the resources that they need," Gillies said, when asked about the money and manpower needed to fight one of America's top crime problems.

He said south Florida was also No. 1 in mortgage fraud and No. 2 in securities fraud, and has significant gang problems.

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  • by Raffle Location: wayne county on Sep 8, 2011 at 01:53 PM
    It`s about time, this system and other Government sponsored programs are being ripped every day. It`s time the Federal and State Government`s wakes up.
  • by Dawg on Sep 8, 2011 at 09:13 AM
    All govt. programs need to have a fraud sweep everyday. The trillions that are stolen from us the taxpayers everyday, could help set this country on the right track again if it were stopped. But it seems the people we elect are happy to have the fraud and do next to nothing to stop it. Guess if people are looking at the other fraud they are not looking at the fraud the elected officials are taking part in.
  • by Anonymous on Sep 8, 2011 at 08:24 AM
    I know Medicaid is being ripped off as well.
    • reply
      by Anonymous on Sep 8, 2011 at 09:15 AM in reply to
      Then report what you know, but don't hold your breath waiting for them to do anything about it.
  • by boxer on Sep 8, 2011 at 08:23 AM
    Is this really a surprise to anyone? Heathcare would be much more affordable if they would crack down on all those greedy cheaters, stealing tax payers money.
  • by Barlow Location: Winterville on Sep 8, 2011 at 07:29 AM
    Nice work by the attorney general. Maybe even if they can't get them all, this will scare some of them into stopping. That is a huge amount of money stolen.
  • by concerned Location: Beulaville NC on Sep 8, 2011 at 05:04 AM
    That not only happens there but also in our surrounding counties. no one has just thought to look over their bill. we put too much trust in our systems.
  • by concerned Location: enc on Sep 8, 2011 at 03:14 AM
    why is it the needy ones of the Medicare system cannot get the help they need? They paid in this money and the government wants to take my money and not pay me back. That is stealing; but people not needing it are out here lying. Please try to get the system straight. This isn't free welfare. We paid for it, not asked to be given anything. Do not take from us who need it and paid for it so others in these big cities can have a life of luxury when I have to pick and choose which necessities I will have this month.
  • by I Fought the Law on Sep 8, 2011 at 03:13 AM
    "We have dozens and dozens of cases to go," said Gillies, referring to a fraud that the FBI has estimated to cost U.S. taxpayers anywhere between $70 billion and $234 billion a year." And this is just Medicare abuse alone!!! Just imagine how much more is being stolen from Social Security, housing assistance, welfare, and other tax based programs. Oh yeah, and wait until the new government assisted healthcare program gets into full swing.....the thieves will feed on that one like a flock of hungry vultures.
    • reply
      by Anon on Sep 8, 2011 at 04:02 AM in reply to I Fought the Law
      I can't imagine numbers that big after looking at my paycheck.
  • by Tyee Location: Hyde County on Sep 8, 2011 at 03:04 AM
    If true, based on my degree in management, the problem starts at the top by selecting good people to oversee this problem from the beginning. Where is our supervision?
    • reply
      by Anonymous on Sep 8, 2011 at 06:01 AM in reply to Tyee
      Campaigning, vacationing, or off somewhere starting a new war. Oh, and sometimes off pandering to a new special interest group.

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