Case Management

News: 91 face charges in $429 million Medicare fraud case

Case Management Weekly, November 7, 2012

Physicians, nurses, and other licensed medical professionals are among 91 individuals in seven cities facing charges for their alleged participation in Medicare fraud schemes involving approximately $429.2 million in false billing, Attorney General Eric Holder and HHS Secretary Kathleen Sebelius said in a joint announcement.

Together, the indictments charge more than $230 million in home healthcare fraud, more than $100 million in mental healthcare fraud, and more than $49 million in ambulance transportation fraud, and millions more in other frauds, the press release said.

HHS also suspended or took other administrative action against 30 healthcare providers following a data-driven analysis and based upon credible allegations of fraud. Under the Patient Protection and Affordable Care Act, HHS is able to suspend payments until the resolution of an investigation.

The defendants face various charges, including conspiracy to commit healthcare fraud, healthcare fraud, anti-kickback violations, and money laundering. The charges are based on a variety of alleged fraud schemes involving various medical treatments and services such as home healthcare, mental health services, psychotherapy, physical and occupational therapy, durable medical equipment and ambulance services.

Most Popular