Tuesday, May 21, 2013

Federal Officials Arrest 89 People in Medicare Fraud Schemes

Federal officials credited the new healthcare law for providing the authority that led to arrest of 89 people in separate Medicare fraud cases last week. The arrests were made in eight cities by the Health Care Fraud Prevention & Enforcement Action Team (HEAT), and CQ reports that they are expected to recover about $223 million to Medicare.

The HEAT Team is a cooperative effort between the Department of Justice and the Department of Health and Human Services.

The Medicare fee for service program processes more than a billion claims per year, and detecting false claims can be a dubious task. The Obama administration estimates that $60 billion per year is lost to fraudulent claims. Since 2007, however, Attorney General Holder and HHS Secretary Sebelius say that federal official have brought 1,500 Medicare fraud cases against individuals who falsely billed Medicare for more than $5 billion.

Included in the arrests last week were 25 people in Miami who falsely billed a total of $44 million in home health care, mental health, occupational and physical therapy, medical equipment, and HIV infusion charges. Four of the 25 were two nurses, a paramedic, and a radiographer. Another case included three defendants who bribed Medicare recipients in order to use their information for the purpose of billing $20 million in false charges. Arrests also took place in Detroit, Houston, Baton Rouge, Los Angeles Brooklyn, Tampa Bay, and Chicago.

Read the full Department of Justice press release here

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