Healthcare Business News

Over 100 accused of Medicare fraud

By Rich Daly
Posted: May 2, 2012 - 4:00 pm ET

A Medicare fraud sweep has resulted in a record number of healthcare workers facing charges and a record number of suspensions of the employers' Medicare participation.

Federal investigators have charged 107 people, including physicians, nurses and other licensed medical professionals, with about $452 million in Medicare fraud, federal officials announced Wednesday in Washington. The arrests also led HHS to take “administrative actions” against 52 of the provider groups that employed those suspects, including suspension of their participation in Medicare.

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The arrests were credited to seven of the nine interagency Medicare Fraud Strike Forces operating in cities with the highest suspected rates of Medicare fraud.

“Today's arrests send a strong message to criminals that the consequences of committing Medicare fraud are serious,” HHS Secretary Kathleen Sebelius said at a news conference announcing the arrests.

The HHS Medicare participation suspensions—authorized by the 2010 federal healthcare law—followed “a data-driven analysis” and credible allegations of fraud, according to a statement from the Justice Department. The law allows HHS to suspend payments until an investigation is complete.

The large group of arrests was the fourth such group of Medicare antifraud enforcement crackdowns announced by the Obama administration.

More such large arrests are likely as the FBI alone has about 2,600 other healthcare fraud cases under investigations, said Sean Joyce, deputy director of the FBI.

The charges announced cover a range of healthcare fraud schemes, including conspiracy to commit healthcare fraud, healthcare fraud, violations of the anti-kickback statutes and money laundering. The charges were directed at several different types of healthcare providers, including home healthcare, mental health services, psychotherapy, and physical and occupational therapy. Other healthcare contractors charged included those providing durable medical equipment and ambulance services.

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