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By Catholic Online (NEWS CONSORTIUM)

10/5/2012 (1 year ago)

Catholic Online (www.catholic.org)

91 defendants accused of bilking medical services to tune of $430 million

Ninety-one individuals - a number which includes doctors, nurses and other medical officials - have been charged with massive Medicare fraud to upwards of $430 million. All kinds of fraud are alleged in the arrests, in particular false billing for services that were either unnecessary or not rendered.

Suspects face charges of conspiracy to commit health care fraud, health care fraud, violations of the anti-kickback statutes and money laundering.

Suspects face charges of conspiracy to commit health care fraud, health care fraud, violations of the anti-kickback statutes and money laundering.

Article Highlights

By Catholic Online (NEWS CONSORTIUM)

Catholic Online (www.catholic.org)

10/5/2012 (1 year ago)

Published in Politics & Policy

Keywords: Medicare fraud, false billing, services not rendered, doctors, nurses, Attorney General Eric Holder


LOS ANGELES, CA (Catholic Online) - Spanning several U.S. cities, some of the allegations include:

- In Houston, Texas, seven individuals are accused of fraudulently billing a community mental health center for $158 million. "The defendants who served as administrators at the hospital paid kickbacks - in the form of cigarettes, food and coupons redeemable for items available at the hospital's 'country stores," Justice Department officials said. "Allegedly, beneficiaries watched television, played games and engaged in other non-PHP activities rather than receiving the services for which the hospital billed Medicare."

- In Brooklyn, 15 individuals, including a doctor and four chiropractors, are charged for their alleged participation in various fraud schemes involving a total of $23.2 million in false billings.

- In Baton Rouge, Louisiana, four defendants, including a licensed practical nurse, are charged for their roles in fraud schemes involving approximately $2.4 million in false claims for medically unnecessary durable medical equipment.
  
Thirty health care providers were either suspended or faced with administrative action after inspectors had analyzed credible evidence of fraud. The Affordable Care Act authorizes the HHS to stop payments until an investigation has been resolved.

Arrests have been made in the cities of Los Angeles, Miami, Dallas, Houston, Tampa, Baton Rouge, Chicago and Brooklyn, N.Y. Among the many indictments, there are charges of more than $230 million in home health care fraud, more than $100 million in mental health care fraud, more than $49 million in ambulance transportation fraud, among many others.

Suspects face charges of conspiracy to commit health care fraud, health care fraud, violations of the anti-kickback statutes and money laundering.
 
"Today's enforcement actions reveal an alarming and unacceptable trend of individuals attempting to exploit federal health care programs to steal billions in taxpayer dollars for personal gain," Attorney General Eric Holder said during a press conference in Washington, D.C.

"Such activities not only siphon precious taxpayer resources, drive up health care costs, and jeopardize the strength of the Medicare program -- they also disproportionately victimize the most vulnerable members of society, including elderly, disabled and impoverished Americans."

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