Charges were filed Wednesday against 91 defendants, including doctors, nurses and other medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $295 million in false billing, announced Attorney General Eric Holder and HHS Secretary Kathleen Sebelius.
Holder and Sebelius were joined in the announcement by FBI Executive Assistant Director Shawn Henry, Assistant Attorney General Lanny A. Breuer of the Justice Department's Criminal Division and HHS Inspector General Daniel R. Levinson.
"The defendants charged in this takedown are accused of stealing precious taxpayer resources and defrauding Medicare – jeopardizing the integrity of our healthcare system and our nation's most critical healthcare program for personal gain," said Holder. "Our highly coordinated, nationwide Strike Force operations are working aggressively to combat Medicare fraud and our anti-healthcare fraud efforts have never been more innovative, collaborative, aggressive – or effective. We will continue to work with our law enforcement partners and partners across government to fight against healthcare fraud."
This coordinated arrests involved the highest amount of false Medicare billings in a single takedown in Strike Force history.
Those arrested are accused of various healthcare fraud-related crimes, including conspiracy to defraud the Medicare program, healthcare fraud, violations of the anti-kickback statutes and money laundering. The charges are based on a variety of alleged fraud schemes involving various medical treatments and services such as home healthcare, physical and occupational therapy, mental health services, psychotherapy and durable medical equipment (DME).
According to court documents, the defendants allegedly participated in schemes to submit claims to Medicare for treatments that were medically unnecessary and oftentimes never provided. In many cases, indictments and complaints allege that patient recruiters, Medicare beneficiaries and other co-conspirators were paid cash kickbacks in return for supplying beneficiary information to providers, so that the providers could submit fraudulent billing to Medicare for services that were medically unnecessary or never provided.
These "arrests are a powerful warning to those who would try to defraud taxpayers and Medicare beneficiaries," said Sebelius. "These arrests illustrate close cooperation between the Medicare program that identified these fraudsters and the law enforcement officials who acted swiftly to cut them off. And our efforts to stop criminals don't end here because the Affordable Care Act gives us new tools to prevent Medicare fraud before it is committed – better protecting seniors and the integrity of the Medicare program for generations to come."
In addition to making arrests, agents also executed 18 search warrants in connection with ongoing Strike Force investigations.
"The warning should be unambiguously clear by now," said Levinson. "We will continue using the combined law enforcement might of Strike Forces around the country to combat healthcare fraud."