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DOJ Charges 243 People in $712M Medicare Fraud Cases

Medicare-FraudDOJ Charges 243 People in $712M Medicare Fraud Cases

The U.S. Justice Department charged 243 people, including 46 doctors, nurses and other medical professionals, with defrauding the Medicare system of $712 million through false billing.

Attorney General Loretta Lynch announced the charges Thursday in Washington, calling the case the largest sweep of individuals in the history of task forces that target such fraud.

“The defendants charged include doctors, patient recruiters, home health-care providers, pharmacy owners, and others,” Lynch said. “They billed for equipment that wasn’t provided, for care that wasn’t needed, and for services that weren’t rendered.”

The defendants were accused of money laundering, conspiring to commit health-care fraud and violating anti-kickback laws. The scams involved treatments ranging from home health care to psychotherapy. The Justice Department alleged that participants in the scams submitted claims to Medicare and Medicaid for treatments that were medically unnecessary and often never provided.

Lynch described a doctor in Michigan who prescribed unnecessary narcotic pain medications to patients in exchange for their information to generate fake billings. Patients who tried to withdraw from the scheme, she said, were threatened with the loss of their drugs.

“Having deepened these patients’ addiction, the doctors then used that addiction to keep patients bound to their scheme,” she said.

FBI Director James B. Comey said the bureau has more than 2,000 open health-care fraud cases nationwide. The fraud artists view the Medicare system as “an ATM that is a freebie to them, but it is filled with taxpayer money.”

“These crimes take money directly away from vulnerable populations,” Comey said. “There are no victimless crimes when it comes to health-care fraud.”

Task forces from the Justice Department and Health and Human Services Department since 2007 have charged more than 2,300 defendants with falsely billing the Medicare program for more than $7 billion, federal prosecutors said.

Government efforts to combat health-care fraud led to the recovery of $3.3 billion in taxpayer dollars in the fiscal year that ended Sept. 30, according to a March report. During that period, U.S. prosecutors opened 924 new criminal health-care fraud investigations, the two departments said in the joint report.

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Article By: Del Quentin Wilber, Visit: www.bloomberg.com