A federal fraud strike force announced Thursday it will bring charges against 53 individuals in the Detroit and Miami area - including doctors, healthcare executives and beneficiaries - for more than $50 million in alleged Medicare false billing.
Agents from the FBI and the Department of Health and Human Services' Office of the Inspector General began executing the arrest warrants Thursday morning as part of a concentrated effort to address fraud in the metro-Detroit area, according to a Department of Justice statement.
Charges were unsealed today against 53 individuals who are accused of various Medicare fraud offenses, including conspiracy to defraud the Medicare program, criminal false claims and violations of the anti-kickback statutes. The strike force operations in Detroit have identified two primary areas – infusion therapy and physical/occupational therapy providers – in which schemes were allegedly orchestrated to defraud the Medicare program, the DOJ said.
According to the indictments, the defendants participated in schemes to submit claims to Medicare for treatments that were medically unnecessary and often never provided. In many cases, the indictments allege, beneficiaries accepted cash kickbacks in return for allowing providers to submit forms saying they had received the unnecessary and unprovided treatments.
“We will continue to work together in the months to come to identify and stop those who would line their own pockets with taxpayer money – those who seek to benefit at the expense of our healthcare system, our economy and our collective well-being,” said FBI Director Robert Mueller.
"Today’s landmark series of arrests in Detroit and across the country demonstrates that healthcare fraud can happen anywhere in America," said Daniel R. Levinson, Inspector General of the Department of Health and Human Services. "We will continue to detect and respond rapidly to emerging fraud schemes to protect our federal healthcare programs and conserve scarce healthcare dollars so critically needed for the care of our beneficiaries."
According to Mueller, Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius, the Detroit strike force is the third phase of a targeted criminal, civil and administrative effort against individuals and healthcare companies that fraudulently bill the Medicare program.
While the indictments were returned by a grand jury in Detroit, individuals were arrested in Detroit and Miami as a result of phase three operations of the strike force, they said.
The joint Department of Justice and Health and Human Services Medicare Fraud Strike Force is a multi-agency team of federal, state and local investigators designed to combat Medicare fraud through the use of Medicare data analysis techniques and an increased focus on community policing, according to a DOJ press release.
"As demonstrated by today’s charges and arrests, we will strike back against those whose fraudulent schemes not only undermine a program upon which 45 million aged and disabled Americans depend, but which also contribute directly to rising healthcare costs that all Americans must bear,” Holder said.
"The vast majority of doctors, patients and medical companies do the right thing and work with the Medicare program to provide access to medical services," he said. "To those who work diligently and ethically to provide medical care through the Medicare program, we will work with you to root out the few who corrupt the system and taint the good reputations of health professionals everywhere."
According to Sebelius, the Obama administration "is committed to turning up the heat on Medicare fraud and employing all the weapons in the federal government’s arsenal to target those who are defrauding the American taxpayer."
"Thanks to cooperation from across the government and some of the best law enforcement professionals in the country, today we were able to save millions of dollars from being lost to criminals and send a powerful message to those who seek to defraud the system, that we are coming after them," she said.
She added that the HHS-DOJ task force doesn't stop "at the jailhouse door."
"Our Medicare program is working closely in partnership with our own and other law enforcement operations to prevent fraud from happening in the first place," she said. "Every dollar we can save by stopping fraud can be used to strengthen the long-term fiscal health of Medicare, bring down costs and deliver better service to Medicare beneficiaries."
The strike force operations in Detroit are part of the Health Care Fraud Prevention and Enforcement Action Team (HEAT), a renewed effort announced in May 2009 between the DOJ and HHS to focus joint efforts to prevent fraud and enforce current anti-fraud laws around the country.