Corporate Compliance

Feds arrest dozens nationwide for Medicare fraud scheme

Compliance Monitor, August 5, 2009

Continuing the trend of increased fraud enforcement, the Medicare Fraud Strike Force arrested 32 suspects in a connection with Medicare fraud schemes that billed the government for medical supplies that were not medically necessary, according to a Department of Justice (DOJ) release.
The bulk of the arrests were made in Houston, where health clinic owners billed Medicare for as much as $4,000 for “arthritis kits”—essentially knee braces, shoulder braces, and heating pads. According to the DOJ, patients said they either did not need the kits or never received them. The strike force also arrested individuals in New York, Boston, and Louisiana in connection with the scheme.
Authorities also broke up a liquid food scam in Houston, in which clinic owners billed Medicare for liquid food (e.g., Ensure) that they never provided to patients. According to the DOJ, some clinics even billed deceased patients.
This major bust comes months after Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius announced they were adding millions of dollars to the fight against healthcare fraud and abuse. The Medicare strike force has targeted Houston, Miami, Los Angeles, and Detroit as hotbeds for medical fraud and abuse, and has recovered $371 million in false Medicare claims and charged 145 people in just two months.

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