Fraud crackdown continues

July 13, 2009

Crackdown on Medicare fraud enforced by DOJ and HHS.

The Medicare Fraud Strike Force in Detroit recently arrested 53 suspects in Miami, Detroit and Denver including physicians, medical assistants, patients, company owners and executives on charges of conspiring to defraud the government program of reportedly $56 million.

According to the indictments, the defendants participated in schemes to submit claims to Medicare for treatments that were in fact medically unnecessary and oftentimes, never provided. In many cases, indictments allege that beneficiaries accepted cash kickbacks in return for allowing providers to submit forms saying they had received the unnecessary and not-provided treatments.

The 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. The operations in Detroit are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a renewed effort announced in May 2009 between the Department of Justice and HHS to enforce current anti-fraud laws around the country.

Since March 2007, the Strike Force has obtained indictments of more than 250 individuals and organizations that collectively have billed the Medicare program for more than $600 million