Providers

Medicare Fraud Cases Given Priority by DOJ-HHS

On July 16, 2010, the departments of Justice (DOJ) and Health and Human Services (HHS) announced charges against 94 people for their alleged participation in submitting more than $251 million in false claims to the Medicare program. The charges stem from an investigation by the Health Care Fraud Prevention and Enforcement Action Team (HEAT) Medicare Fraud Strike Force. The investigation charged providers in Miami, Baton Rouge, Brooklyn, Detroit, and Houston.

"We are using aggressive and innovative techniques in our investigations," said Assistant Attorney General Lanny A. Breuer. "Real-time data analysis allows us to focus our resources where the fraud is the most egregious. And undercover operations, wire taps and other lawful covert tactics allow us to investigate and stop these schemes as they are happening. I can promise that you will see more of these kinds of proactive efforts on our part."

The operation was the largest federal health care fraud takedown since Medicare Fraud Strike Force operations began in 2007. More than 360 law enforcement agents from the Federal Bureau of Investigation (FBI), the HHS Office of Inspector General (OIG), multiple Medicaid Fraud Control Units, and other state and local law enforcement agencies participated in this investigation.

The various Medicare fraud-related offenses included:

  • Conspiracy to defraud the Medicare program
  • Criminal false claims
  • Violations of the anti-kickback statutes
  • Money laundering

The charges are based on a variety of fraud schemes, including physical therapy and occupational therapy schemes, home health care schemes, HIV infusion fraud schemes, and durable medical equipment (DME) schemes.


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