Medicare fraud: US authorities charge 107 doctors, nurses and social workers in 7 cities

GlobalPost

A Medicare fraud crackdown on 107 medical professionals by US authorities on Wednesday is the most expensive single healthcare fraud case in US history, CBS News reported

The fraud allegedly cost the taxpayer-funded program $452 million, and was perpetrated by "people up and down the chain of healthcare providers, from doctors, nurses, and licensed clinical social workers to office managers and patient recruiters," said Lanny Breuer, assistant attorney general for the Justice Department's criminal division, according to CBS News. 

Hundreds of federal agents raided businesses, seized documents, and made arrests in seven cites on Wednesday, including Miami, Los Angeles, Houston, Detroit, Chicago, Tampa, and Baton Rouge, CBS reported. The government also halted payments to 52 health care providers as part of the investigations, the Associated Press reported

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“We are determined to bring to justice those who violate our laws and defraud the Medicare program for personal gain," said Attorney General Eric Holder in a statement issued on Wednesday. "As [this] takedown reflects, our ongoing fight against health care fraud has never been more coordinated and effective.”

Of the 107 defendants in the case, 87 were arrested by federal agents on Wednesday, according to the Los Angeles Times. The rest are either expected to surrender voluntarily or were being searched for, the Times reported. 

The most serious cases of fraud were in Louisiana, where seven people in Baton Rouge were arrested and charged with eight counts — including conspiracy and healthcare fraud — for billing Medicare for around $225.6 million in unnecessary services, according to Reuters. 

In another case in Miami, Florida, 10 people were charged for altering their paperwork to justify unnecessary services for patients, allegedly seeking $63 million in reimbursements, Reuters reported. 

This is not the first major health care fraud round-up: in September, officials charged 91 people who defrauded the taxpayer-funded program out of $295 million. 

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The FBI is currently investigating over 2,600 cases of healthcare fraud with more than 500 agents and analysts, Reuters reported. Since March 2007, over 1,300 people have been charged for falsely billing Medicare more than $4 billion, the Justice Department said. 

“Medicare fraud also exposes some of our most vulnerable citizens to identity theft, and, in some cases, endangers patients’ lives,” said Gary Cantrell, Deputy Inspector General for Investigations for Health and Human Services, the AP reported. “The indictments announced [Wednesday] demonstrate that we’re fighting back.”

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