Feds Bust 91 For $429.9 Million in Medicare Fraud

Fierce Healthcare has;
Feds Bust 91 People In $429.9 Million Medicare Fraud Takedown
October 5, 2012 | By Alicia Caramenico

The Centers for Medicare & Medicaid Services charged 91 people in seven cities for Medicare fraud totaling $429.2 million in alleged false billing. The massive bust signals more huge takedowns from authorities.

Within a 24-hour period, most of the charged individuals, which include doctors, nurses, healthcare company owners and other licensed medical professionals, were arrested or surrendered, the agency announced yesterday. The charges include conspiracy to commit healthcare fraud, healthcare fraud, anti-kickback violations and money laundering.

U.S. Department of Health & Human Services Secretary Kathleen Sebelius cited the reform law for providing new tools to fight fraud, as well giving new authority to suspend payments until fraud allegations have been resolved, according to the CMS statement.

In Miami, the feds charged 33 people for their alleged involvement in fraud schemes that led to $204.5 million in false billings for home healthcare, mental health services, and occupational and physical therapy. Seven hospital administrators in Houston face charges for giving Medicare patients cigarettes and hospital gift shop coupons in exchange for their participation in partial hospitalization program of mentally ill patients.

Yesterday's Medicare fraud bust follows another massive takedown in May, when officials arrested more than 100 people and charged them with defrauding the government of more than $450 million.

To further healthcare fraud prevention and monitoring, CMS in July opened up a $3.6 million facility in Baltimore that brings together clinicians, data analysts, fraud investigators and policy experts in one physical space to speed up anti-fraud efforts.

To learn more:
- read the CMS statement

Related Articles:
AHA: Hospital mistakes aren't fraud
DoJ, HHS boasts record year in $4.1B healthcare fraud recovery
3 schemes that drained Medicare of millions
OIG: HHS to target hospitals in continued fraud crackdown

Thank You Fierce Healthcare and Ms Caramenico



Gee Whiz. Wonder where they might find some more?


This next, is from the CMS release:

"Together, those indictments charge more than $230 million in home health care fraud; more than $100 million in mental health care fraud and more than $49 million in ambulance transportation fraud; and millions more in other frauds."