Thread: Doctors among those indicted in $251M Medicare scams

Doctors among those indicted in $251M Medicare scams

Posted 7m ago
By Kelli Kennedy, Associated Press Writer

MIAMI — Federal authorities said Friday they are conducting the largest Medicare fraud bust ever and arrested dozens of suspects accused in scams totaling $251 million.

Several doctors and nurses were among those arrested in Miami, New York City, Detroit, Houston and Baton Rouge, La., accused of billing Medicare for unnecessary equipment, physical therapy and HIV treatments that patients typically never received. Ninety-four suspects were indicted, and authorities said 36 people had been arrested as of Friday morning.

More than 360 agents participated in Friday's raids, announced by Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius at a health care fraud prevention summit in Miami. Officials said they chose Miami because it is ground zero for Medicare fraud. Authorities indicted 33 suspects in the Miami area, accused of charging Medicare for about $140 million in various scams.

"With today's arrests we're putting would-be criminals on notice: Health care fraud is no longer a safe bet," Holder said Friday.

Cleaning up an estimated $60 billion to $90 billion a year in Medicare fraud will be key to paying for President Obama's proposed health care overhaul. Federal officials have promised more money and manpower to fight fraud, setting up strike forces in several cities.

Around the country, the schemes have morphed from the typical medical equipment scam in which clinic owners billed Medicare dozens of times for the same wheelchair, while never giving the medical equipment to patients. Now, officials say, the schemes involve a sophisticated network of doctors, clinic owners, patients and patient recruiters.

Violent criminals and mobsters are also tapping into the scams, seeing Medicare fraud as more lucrative than dealing drugs and having less severe criminal penalties, officials said.

Agents bugged a medical center in Brooklyn, N.Y., where eight people are charged with running a $50 million scam that submitted bogus claims for physical therapy. Clinic owners paid patients, including undercover agents, in exchange for using their Medicare numbers and a bonus fee for recruiting new patients. Recording devices captured hundreds of kickback payments in a private room where a man sat at a table and did nothing but pay patients all day, authorities said.

In a separate Brooklyn case, authorities indicted six patients who shopped their Medicare numbers to various clinics. More than 3,744 claims were submitted on behalf of one woman in the past six years. The patients did not receive the services billed to Medicare, authorities said.

"Today's arrests illustrate how health care fraud schemes can replicate virally and migrate rapidly across communities," said Daniel Levinson, inspector general of the U.S. Department of Health and Human Services, which oversees Medicare.

Federal authorities launched a strike force in Miami in 2007 to target the problem. The program has since expanded to seven cities and is responsible for more than 720 indictments that collectively have billed the Medicare program for more than $1.6 billion.

Miami-Dade County received about $520 million from Medicare in home health care payments intended for the sickest patients in 2008, which is more than the rest of the country combined, according to a federal report. Only 2% of the patients live here.

It used to take 90 days before the government detected a scam. By then, the crooks were long gone, sometimes with millions of dollars. Now authorities get billing data as it's submitted, allowing them to catch suspects in real time, "as opposed to the typical pay and chase model we've had for years," said Gerald Roy, assistant inspector general for investigations.

http://www.usatoday.com/money/industrie ... cams_N.htm

Department of Justice Press Release
For Immediate Release
July 16, 2010

U.S. Department of Justice
Office of Public Affairs
(202) 514-2007/TDD (202) 514-1888


Medicare Fraud Strike Force Charges 94 Doctors, Health Care Company Owners, Executives, and Others for More Than $251 Million in Alleged False Billing

Early Morning Takedown Leads to Arrests, Charges, and Execution of Search Warrants in Miami, Baton Rouge, Brooklyn, Detroit, and Houston

WASHINGTON—Ninety-four people have been charged for their alleged participation in schemes to collectively submit more than $251 million in false claims to the Medicare program in the continuing operation of the Medicare Fraud Strike Force in Miami; Baton Rouge, Louisiana; Brooklyn, New York; Detroit; and Houston, announced Attorney General Eric Holder, Department of Health and Human Services (HHS) Secretary Kathleen Sebelius, FBI Director Robert Mueller, and Daniel R. Levinson, Inspector General of HHS. The operation announced today is the largest federal health care fraud takedown since Medicare Fraud Strike Force operations began in 2007.

The joint DOJ-HHS Medicare Fraud Strike Force is a 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. More than 360 law enforcement agents from the FBI, HHS-Office of Inspector General (HHS-OIG), multiple Medicaid Fraud Control Units, and other state and local law enforcement agencies participated in today’s operation.

“Our continued Strike Force operations reflect the unprecedented commitment that inspired the creation of the Health Care Fraud Prevention and Enforcement Action Team in May 2009,â€

Hushin' Russian in Brooklyn med 'fraud'

By JANON FISHER and DAN MANGAN
Last Updated: 7:10 AM, July 17, 2010
Posted: 2:43 AM, July 17, 2010

Keep those lips zipped, comrade -- and help us rip off Uncle Sam for $72 million!

A Brooklyn medical office used a Soviet-era propaganda poster to tell Russian-immigrant patients to keep quiet about kickbacks they were getting for letting doctors submit thousands of bogus Medicare claims in their names, federal prosecutors revealed yesterday.

"Don't gossip!" warned the Russian-language poster that prominently hung in the "kickback room" of the Bay Medical office on Bay Parkway -- where patients literally lined up for illegal payoffs of a couple of a hundred dollars or so each.

Paul Martinka
QUIET PLEASE: Feds yesterday enter Bay Medical's offices, where prosecutors say this poster urged patients to keep mum about a $72 million Medicare scam. Also busted in the feds' sweep was Valentina Mushinskaya, here outside Brooklyn court yesterday.

But not everyone kept their mouths shut.

Federal authorities got several people to rat out the alleged scam and yesterday arrested dozens of doctors, employees and patients of Bay Medical and other Medicare "mills" elsewhere in Brooklyn and in Miami, Detroit, Houston and Baton Rouge, La.

It is the largest Medicare-fraud prosecution ever, totaling $251 million in funds swindled from the federal health-insurance program.

Featuring a large drawing of a woman holding an index finger to her lips, the not-so-helpful poster reads: "Keep your eyes open. These days even the walls have ears. Chatter and gossip go hand in hand with treason."

Those threats helped Bay Medical steal $72 million by submitting fraudulent claims, prosecutors said.

Among those busted was 82-year-old Brooklyn resident Valentina Mushinskaya, who allegedly accepted a $1,500 kickback in exchange for allowing doctors to submit her Medicare account for 3,774 medical services over six years.

Prosecutors said her doctors at Solstice Wellness Center in Rockaway Park fraudulently billed Medicare $259,902 and ended up being reimbursed $141,161 for those services, which the Ukrainian immigrant Mushinskaya never received.

After Mushinskaya was released yesterday on $35,000 bond, her nephew proclaimed she had no idea a scam was being perpetrated in her name -- and griped that authorities had handcuffed the diabetic woman when they arrested her.

"She feels ashamed, absolutely shocked," Vladimir Olshanski said as his aunt hobbled along with a cane as she was swarmed by reporters at Brooklyn federal court.

Seven other elderly patients of Solstice also were charged.

Announcing the crackdown yesterday, Brooklyn US Attorney Loretta Lynch said, "Those who would defraud these programs not only hurt some of the most needy and vulnerable but also indirectly impact all Americans."

janon.fisher@nypost.com

http://www.nypost.com/p/news/local/broo ... YzWlvvIGpM