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Medicare Strike Force Operation Results in Largest Fraudulent Medicare Billing Takedown in Strike Force History

On September 7, 2011, Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius announced that a Medicare Strike Force operation resulted in a nationwide takedown involving the highest amount of fraudulent Medicare billings in a single Medicare Strike Force takedown. The takedown was operated across eight cities and led to 91 defendants, many of which are health care professionals, being charged for their participation in Medicare fraud schemes which accumulated roughly $295 million in fraudulent billings. Some of the indictments are described below:

  • 45 defendants in Miami were charged for their participation in Medicare fraud schemes which totaled $159 million in fraudulent billings for home health care, mental health services, DME, physical therapy and HIV infusion. One of these schemes allegedly involved recruiters being paid by a mental health care facility to recruit beneficiaries to the center who were ineligible to receive such services.
  • Two defendants in Houston were charged with fraudulently billing $62 million for home health care services and DME. The scheme allegedly involved one defendant who sold beneficiary information to 100 different home health care agencies in the Houston area who then used that information to fraudulently bill Medicare for services that were either medically unnecessary or never provided.
  • In Baton Rouge, ten defendants were charged with participating in schemes that billed Medicare for $24 million worth of home health care services and DME in which $19 million of the home health care services were either medically unnecessary or never provided.
  • Other Medicare fraud schemes were allegedly conducted in Los Angeles, Brooklyn, Dallas, Chicago and Detroit which were responsible for millions of dollars worth of false Medicare billings.

HHS Inspector General Levinson advised, “the warning should be unambiguously clear by now…we will continue using the combined law enforcement might of Strike Forces around the country to combat health care fraud.”

These indictments are another example of the government’s focus on preventing fraud and abuse in the Medicare and Medicaid programs throughout the country, including the Detroit area. For more information on Medicare Fraud defense, or assistance with interpreting and understanding Medicare and Medicaid regulations, including the anti-kickback statute, please contact a Wachler & Associates attorney at 248-544-0888.