|Articles|July 13, 2009

Fraud crackdown continues

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


Related to this article

Pooja Roy, M.D., on Precedex-induced fever | CHEST 2026
Pooja Roy, M.D., of Houston Methodist Hospital, discusses how Precedex (dexmedetomidine), an ICU sedative, sometimes triggers noninfectious fever, sparking costly sepsis workups, and the need for a test could help clinicians identify the drug as a cause of fever in ICUs.
Eric K. Singhi, M.D., on lung cancer among younger adults
Young-onset lung cancer often strikes nonsmokers, and current screening based on smoking is not likely to find it, says Singhi, an assistant professor at UT MD Anderson Cancer Center in Houston. New risk-based screening, liquid biopsies, and breath tests aim earlier detection.