Massive Medicare fraud takedown; 240 arrested

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More than 240 individuals—including doctors, nurses, and other licensed professionals—were arrested this week for their alleged participation in Medicare fraud schemes involving approximately $712 million in false billings.

The arrests, which began Tuesday, were part of a coordinated operation in 17 cities by Medicare Fraud Strike Force teams, which include personnel from the FBI, the Department of Health and Human Services (HHS), the Department of Justice (DOJ), and local law enforcement. The Strike Force’s mission is to combat health care fraud, waste, and abuse.

At a press conference on Thursday, at DOJ Headquarters in Washington, D.C., officials said the arrests constituted the largest-ever health care fraud takedown in terms of both loss amount and arrests.

“These are extraordinary figures,” Attorney General Loretta Lynch said. “They billed for equipment that wasn’t provided, for care that wasn’t needed, and for services that weren’t rendered.”

The charges are based on a variety of alleged fraud schemes involving medical treatments and services. According to court documents, the schemes included submitting claims to Medicare for treatments that were medically unnecessary and often not provided. In many of the cases, Medicare beneficiaries and other co-conspirators were allegedly paid cash kickbacks for supplying beneficiary information so providers could submit fraudulent bills to Medicare. Forty-four of the defendants were charged in schemes related to Medicare Part D, the prescription drug benefit program, which is the fastest growing component of Medicare and a growing target for criminals.

“There is a lot of money there, so there are a lot of criminals,” said FBI Director James B. Comey. He described how investigations leveraged technology to collect and analyze data, and rapid response teams to surge where the data showed the schemes were operating. “In these cases, we followed the money and found criminals who were attracted to doctors offices, clinics, hospitals, and nursing homes in search of what they viewed as an ATM.”

Since their inception in 2007, Strike Force teams in the nine cites where they operate have charged more than 2,300 defendants who collectively falsely billed Medicare more than $7 billion. Today’s announcement marked the first time that districts outside Strike Force locations have participated in a national takedown; those districts accounted for 82 of the arrests this week.

The cases:

In Miami, 73 were charged in schemes involving about $263 million in false billings for pharmacy, home health care, and mental health services.

In Houston and McAllen, 22 were charged in cases involving more than $38 million. In one case, the defendant coached beneficiaries on what to tell doctors to make them appear eligible for Medicare services and then received payment for those who qualified. The defendant was paid more than $4 million in fraudulent claims.

In New Orleans, 11 people were charged in connection with home health care and psychotherapy schemes. In one case, four defendants from two companies sent talking glucose monitors across the country to Medicare beneficiaries regardless of whether they were needed or requested. The companies billed Medicare $38 million and were paid $22 million.

“We will not stop here,” HHS Secretary Sylvia Mathews Burwell said. “We will work tirelessly to prevent these programs from becoming targets and fight fraud wherever we find it.”

More than 900 law enforcement officials participated in the three-day sweep. Those arrested include 46 licensed medical professionals, including 19 doctors. Since 2007, the Medicare Fraud Strike Force has prosecuted more than 200 doctors and more than 400 medical professionals.

In fiscal year 2014, DOJ and HHS health care fraud and prevention efforts recovered nearly $3.3 billion. Over the past five years, DOJ specifically has recovered more than $15 billion in cases involving health care fraud. The average prison sentence in Strike Force cases in fiscal year 2014 was more than four years, though some prosecutions in recent years resulted have in sentences of 50 years.

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  • Randy Morris

    Not a one of these people could hold a candle for the TWO Florida residents that has stolen BILLIONS in Medicare dollars since 1983. In December 2014 Jeb Bush resigned as the sole director of Tenet healthcare of Dallas. A job he took i 2007 after leaving the governor’s office at a salary and benefits of $37,000. per day! In 2013 regulators released government documents to prove Tenet had paid ONE BILLION IN FINES FOR MEDICARE FRAUD! So how did he do this? Corporate records and new releases prove that Tenet Healthcare merged with Columbia in 1997 after jeb’s partner Rick Scott fled Columbia with $300 MILLION and hs stocks they merged Columbia into Tenet!

    So, where did Columbia Hospitals that made Rick Scott so rich really come from? Columbia was created in part from the assets of INTERNATIONAL MEDICAL CENTERS [IMC} the first major Medicare Fraud scheme exposed in Miami (The USA) in 1987.

    As the story goes Jeb Bush and his frsrt Medicare Fraud partner Miguel Recarey, Jr. (A Cuban exiled mobster) got the start up money for IMC from Tampa Mob Boss Santo Trafficante, Jr. (Who was run out of Cuba by Fidel Castro in 1959). By 1983 Jeb with the help of his father then VP George Herbert Walker Bush had arranged a $30 MILLION DOLLAR PER MONTH MEDICARE CASH FLOW! For treating the wounded Contra Rebels in their Iran-contra Drugs for guns scam. Jeb’s adopted brother Bill Clinton was picking up at least some of the cocaine at his Mena Airport in Little Rock, Ark.
    All was well until a disgruntled HHS investigator named Weinstein discovered the fraud. He put enough pressure on the feds to indict someone and that was Recarey. Daddy Bush arranged a $2 MILLION IRS tax refund for Recarey who fled to Jeb’s old stomping grounds in Venezuela before the indictment come down. With Recarey gone Jeb and daddy arranged for the IMC assets to be stored in trust with Humana who renamed it GALEN. Then Jeb, daddy and brother George Walker Bush brought Rick Scott their Dallas, TX lawyer and partner with GW in the Texas Rangers along with Richard Rainwater the Bush family investor GURU [who hired Micheal Eisner in 1984 to take over Disney for the Bass Brothers] to come to Miami and pick up the pieces of IMC along with the $30 MILLION A MONTH CASH COW! Rick Scott, Richard Rainwater, George and Jeb Bush and their TN HCA hospital owners Tommy and Billy Frist threw everything together to create Columbia/ HCA and it was the goose that laid the golden egg until 1997 when they all regrouped to create Tenet healthcare. That same year Jeb and George’s cousin Jonathan Bush entered the scams by creating a computerized medical billings program to bill and direct deposit the fruits of their crimes – Athen Health also added the digital patient medical records storage required by the Obamacare which was also created with the help of the Bush brothers and their cousin. One one of these people they claim to have arrested could have possible stolen enough to pay a Billion in fines and stay in business like Jeb Bush and Rick Scott and their over thirty years of ongoing Medicare Frauds which are continuing to this very day!

  • Randy Morris

    Only the little people can get arrested for Medicare Fraud and it took 900 cops to round these people up when it would have only taken one cop to get the biggest two Medicare thieves in US history who are right under their noses every day!