Thread: A MAJOR CRACKDOWN On Health Care Fraud

F.B.I. Press Release

A MAJOR CRACKDOWN On Health Care Fraud

06/24/09

This afternoon, we joined with the Department of Justice and the Department of Health and Human Services in announcing the unsealing of indictments against 53 people in a combined enforcement effort specifically targeting fraud schemes that threaten Medicare…and our country’s most vulnerable citizens—seniors, people with disabilities, and low-income Americans.

Agents from the FBI and the Health and Human Services (HHS) Inspector General’s Office have already begun arresting the defendants in Detroit and Miami. These defendants were the subjects of several separate health care fraud investigations by the new Detroit Medicare Fraud Strike Force, comprised of FBI and HHS agents and Department of Justice (DOJ) prosecutors. Combined, the subjects are accused of conspiring to submit more than $50 million in false claims to Medicare.

Podcast: Inside the FBI
A special agent describes the health care fraud issue.

Today’s arrests involved at least nine Medicare provider companies and a number of company executives, doctors, therapists, medical recruiters, medical assistants, and even some Medicare beneficiaries who were willing to go along with the schemes in exchange for money.

The two primary types of fraud schemes being perpetrated include:

Physical therapy/occupational therapy fraud: The crux of these schemes was billing Medicare for services not rendered. In most cases, the subjects created fictitious patient files by paying Medicare beneficiaries, therapists, and doctors to fill out and sign documentation indicating services had been provided when in fact they had not been. These phony files were then systematically distributed to Medicare providers for illicit billing.

Infusion therapy fraud: Several Michigan infusion therapy companies providing medication for AIDS, HIV-positive, and Hepatitis C patients were allegedly billing Medicare for services not actually performed, were medically unnecessary, or were medically unlikely (medicines not normally prescribed for particular conditions). Note: infusion therapy involves giving medicine intravenously to patients whose conditions are so severe they can’t be treated with oral medication.

Officials announcing the indictments included, from left, Robert Mueller, FBI DIrector; Eric Holder, Attorney General; and Kathleen Sebelius, HHS Secretary.

To investigate health care fraud, Director Robert Mueller said that the FBI is focused on “partnerships, intelligence, and information-sharing.â€

The biggest health care fraud is that illegals and anchors are getting Free Medical care via the American tax payers.