Federal officials are combining forces, launching unprecedented sting operations and announcing they will be tougher than ever on Medicare and Medicaid fraud.
On July 16, Attorney General Eric Holder announced “the largest federal healthcare fraud takedown in the nation's history,” involving 94 people – including physicians, medical assistants, healthcare company owners and executives – in four cities. The defendants were charged in alleged schemes to submit more than $251 million in false Medicare claims.
Twenty-four Miami defendants were charged for alleged fraud schemes totaling approximately $103 million, Holder said. Additional arrests were made in Baton Rouge, La., Brooklyn and Detroit.
The schemes involved submitting claims to Medicare for treatments that weren’t medically necessary and often never provided, he said.
According to Holder, the Medicare Fraud Strike Force, a joint initiative between the Departments of Justice and Health and Human Services, led the sting operation. More than 360 law enforcement agents from the FBI, the HHS' Office of Inspector General, multiple Medicaid Fraud Control Units and other federal, state and local law enforcement agencies participated.
“The days of scamming dollars from our healthcare system are over,” said HHS Secretary Kathleen Sebelius. Federal agencies are using funding from the Affordable Care Act to ramp up fraud recovery programs nationwide, she added.
Sebelius said the government plans to launch real-time investigations if something in a healthcare claim seems to be “really awry.”
Gary Grindler, acting Deputy Attorney General, said this is the first time there has been a cabinet-level effort to fight Medicare and Medicaid fraud. In 2009, the federal government had a record-setting year, with 800 indictments and 600 convictions.
The government plans to set up Medicare Fraud Strike Force units in 20 additional cities, involving Every U.S. Attorney General’s office, Grindler said.
Peter Budetti, head of the Center for Program Integrity – a new federal office dedicated to finding and preventing fraud – said a new South Florida hotline is receiving thousands of tips a day from seniors who suspect fraud.
“And we’re investigating all of them,” he said.