Fraud: Strike Force strikes again; Sen. Grassley demands Medicare audit

Saturday, December 19, 2009

WASHINGTON - The Medicare Fraud Strike Force has struck again, arresting 30 people who allegedly billed Medicare for more than $61 million in false claims, government officials announced last week.

They also announced they're expanding Strike Force operations into Brooklyn, N.Y.; Tampa, Fla.; and Baton Rouge, La.

"When President Obama took office, he promised a new commitment to cracking down on the criminals who steal billions of dollars from Medicare each year through fraudulent claims," stated HHS Secretary Kathleen Sebelius in a release. "These Strike Force operations will allow us to concentrate our agents and resources on the criminal hubs where we know a significant share of fraud occurs."

The Strike Force is a joint operation by the Department of Health and Human Services and the Department of Justice. Federal, state and local investigators use Medicare data analysis techniques and community policing to combat fraud.

Most of the 25 arrests announced last week took place in Miami, with four in Detroit and one in Brooklyn. Charges range from conspiracy to defraud Medicare and launder money to making false statement and receiving kickbacks.

The Strike Force was launched in March of 2007 in Miami and has grown to include Los Angeles and Houston. To date, the Strike Force has obtained indictments against more than 460 individuals and organizations accused of defrauding Medicare of more than $1 billion.

Sen. Grassley demands Medicare audit

WASHINGTON - Sen. Chuck Grassley, R-Iowa, wants to know why, for the second year in a row, the Department of Health and Human Services has failed to deliver an annual assessment of the level of improper payments for Medicare.

In a letter to Acting Administration Charlene Frizzera last week, Grassley pointed out that DHHS hasn't released Comprehensive Error Rate Testing (CERT) reports for fiscal years 2008 or 2009. CMS established the CERT program in 2003 to monitor the accuracy of Medicare fee-for-service payments and report improper payment rates to Congress on an annual basis

Reportedly, the reports haven't been released due to controversy over the methodology used to calculate the improper payment rates.

"Without this kind of assessment, administrators and policymakers aren't galvanized, as they ought to be, to do everything possible to better safeguard program dollars for beneficiaries and taxpayers," Grassley stated in a release. "This is especially problematic in light of the impending insolvency of Medicare. Whatever the reason for the agency's inability o provide the data, the result is ineffective management of scarce Medicare dollars."