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Physicians, Nurses, Healthcare Execs Charged with Fraud in Largest-Ever Federal Takedown

Source: LA Times

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Posted on 18 Feb 2011

In what officials described as the nation's "largest-ever federal healthcare fraud takedown", the federal government's Medicare Fraud Task Force on Thursday brought criminal charges against doctors, nurses and healthcare company executives - a total of 111 people in nine cities.

According to authorities, the defendants cheated the government out of more than $225 million in false billing schemes that included fraudulent claims, kickback operations, money laundering and identity theft.

The sweep of arrests was so massive that it took more than 700 federal agents from the FBI and the Health and Human Services Department to round up the suspects, plus serve another 16 search warrants around the country in connection with ongoing investigations.

"Our message is clear," said Asst. Atty. Gen. Lanny A. Breuer of the Justice Department's Criminal Division. "We are determined to put Medicare fraudsters out of business."

Daniel R. Levinson, inspector general for the Health and Human Services Department, said, "We will not tolerate criminals lining their pockets at the expense of Medicare patients and taxpayers."

Since the task force was started in March 2007, 990 people have been charged in false billing schemes totaling more than $2.3 billion and nearly 750 of them have been convicted. In addition, the federal, state and local task force last year recovered $4 billion in fines and other restitution payments on behalf of taxpayers that had been lost to corruption.

The charges brought Thursday run the gamut of offenses. Some are accused of submitting claims to Medicare for treatments that were medically unnecessarily or never provided. Some are suspected of recruiting patients for hospitals and doctor's offices, and then pocketing lucrative cash kickbacks.

Others are accused of setting up phony schemes involving home healthcare, physical and occupational therapy, nerve conduction tests and prescription medicine. In one case, authorities said, a podiatrist in Detroit billed the government for removing toenails that were never removed.

In Los Angeles, authorities said five suspects schemed to defraud Medicare of more than $28 million in false claims for medical equipment and home healthcare. In Chicago, authorities said, 11 suspects were connected to businesses that billed Medicare more than $6 million for home healthcare, diagnostic testing and prescription drugs.

Other arrests were made in Brooklyn, N.Y.; Houston; Dallas; Miami; Tampa, Fla.; and Baton Rouge, La.

Breuer said the task force had become increasingly sophisticated, developing new cases quickly, some within two months. "We're taking real data in real time and bringing the cases," he said.

Atty. Gen. Eric H. Holder Jr. said the average prison sentence has been 43 months — a term he called "a pretty substantial hit."

Holder saw an extra benefit in keeping the task force running. "After these cases are announced," he said, "after these takedowns occur, we see pretty clearly substantial drops in the number of suspicious claims that are made. So I think the prosecution does have an important effect."


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