Gov’t announces ‘largest takedown in history’

Friday, June 19, 2015

WASHINGTON – A nationwide sweep led by the Medicare Fraud Strike Force has resulted in charges against 243 individuals, including 46 doctors, nurses and other licensed medical professionals.

The individuals have been charged for their alleged participation in Medicare fraud schemes involving about $712 million in false billings, the Department of Health and Human Services announced this week.

“This action represents the largest criminal health care fraud takedown in the history of the Department of Justice, and it adds to an already remarkable record of enforcement,” said Attorney General Loretta Lynch. “The defendants charged include doctors, patient recruiters, home health care providers, pharmacy owners, and others. They billed for equipment that wasn’t provided, for care that wasn’t needed, and for services that weren’t rendered.”  

The defendants are charged with various healthcare fraud-related crimes, including conspiracy to commit healthcare fraud, violations of anti-kickback statutes, money laundering and aggravated identify theft. The charges are based on a variety of alleged fraud schemes involving various medical treatments and services, including home health care, psychotherapy, physical and occupational therapy, DME and pharmacy fraud.

In one case in Los Angeles, for example, a doctor is charged with causing almost $23 million in losses to Medicare through his own fraudulent billing and referrals for DME, including more than 1,000 expensive power wheelchairs and home health services that were not medically necessary and often not provided.

Including this week’s enforcement actions, nearly 900 individuals have been charged in national takedown operations, involving more than $2.5 billion in fraudulent billings.

The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. Since their inception in March 2007, Strike Force operations in nine locations have charged more than 2,300 defendants who collectively have falsely billed the Medicare program for over $7 billion.