Doctors, nurses, individuals indicted in massive Medicare fraud

By Catholic Online (NEWS CONSORTIUM)
10/5/2012
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.

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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."

� 2012, Catholic Online. Distributed by NEWS CONSORTIUM.

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

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1 - 2 of 2 Comments

Kasoy
7 months ago
When you have an unlimited source of funds to a social program sponsored by government that can easily raise taxes or print money, corruption naturally rears its greedy head. Privatization is the better option. Stricter checks and balances minimize fraud and improve the service.
Bill Sr.
7 months ago
Any numbers of heavily funded government run programs, many which have overlapping benefits or services, are soft targets for those inclined to seek ways to siphon off a portion of the billions of taxpayer dollars flowing out of our federal government either directly or through state and local channels. The providers of the bounty are our legislators who make careers out of pandering to every group they can identify as in need of assistance to sustain themselves. This is how they manage to feather their nests and partially fund their reelection. That is bad enough but the head of this beast of bureaucracy which needs to be cut off is the undeniable inherent lack of oversight and stringent supervision with constant auditing and monitoring which should be required as an integral part of every program using taxpayer dollars. In privately run programs employees found responsible of negligence in processing claims or details resulting in the loss of even a few thousand dollars along with their superiors would be fired on the spot. That rarely happens in government run operations. It is often sweep under the rug and the people are transferred to another operation. We should not be thinking of how proud we are of the AG discovering the culprits a few years and a billion dollars after the fact, rather we should be asking how in the world did this go on unnoticed year after year if we indeed had competent management in place charged with responsibility to protect against the obvious opportunities swindlers have to cash in on the bloated programs. He should be head hunting for those at every level of management who were negligent in performance of duty. But do not lose any sleep waiting for that to happen because he is a government employee himself and as usual the losses can be made up by another increase in taxes.

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