New task force strikes down Medicare fraud

Sunday, May 13, 2007

MIAMI - A new fraud initiative called Medicare Strike Force resulted in the arrests last week of 24 individuals for allegedly providing false prescriptions for compounded inhalation medications.

None of the meds were used for patients, according to investigators. One of the individuals charged with mixing the drugs isn't a pharmacist but an air conditioner repairman.

Medicare Strike Force is a partnership between CMS, the U.S. Attorney's Office, the FBI and the U.S. Department of Health and Human Services. It was formed to combat Medicare fraud using real-time analysis of Medicare billing data from the Medicare Program Safeguard Contractors (PSCs) and claims data from the Health Care Information System. Since it began in March, the strike force has indicted 34 cases for a total of $142 million in fraudulent billing.

If convicted, many of those investigated face up to 20 years in prison on charges of conspiracy to defraud the Medicare program, filing criminal false claims and violations of anti-kickback statutes.

The strike force augments ongoing fraud enforcement efforts in South Florida, according to investigators. Since announcing a federal-state healthcare fraud initiative in 2005, the U.S. Attorney's Office has filed more than 130 criminal cases, charging nearly 200 defendants with federal violations in various schemes. Collectively, defendants billed Medicare $300 million and received more than $150 million in reimbursements, most involving DME or home infusion.

Officials said they expect to expand their investigation beyond southern Florida in the months ahead.