Federal officials in Washington just finished what they are calling a “nationwide takedown” of medical professionals who have been charged with Medicare fraud. This time, 107 people have been accused of fraudulently billing Medicare for a total of almost half a billion dollars. This is the latest effort to reduce Medicare fraud in order to keep the cost of Medicare manageable.
In September of 2011, the federal government strengthened the insurance fraud laws. The changes increased the length of prison terms for people who commit insurance fraud. It added additional people to the strike force teams. New technology started being used by investigators that allowed them to see insurance claims “in real time”. This allowed them to see patterns before the bills were paid out.
The strike force went after people who were committed Medicare fraud. This could include money laundering, providing “kickbacks” to people who gave out Medicare beneficiary numbers, and billing Medicare for home health care that was not provided or billing Medicare for medical equipment that was not used by patients. In September of 2011, 91 people were charged with attempting Medicare fraud that totaled to around $295 million.
Now, 107 people, (who were doctors, nurses, and social workers), have been charged in a “nationwide takedown” of medical professionals who have been accused of fraudulently billing Medicare out of almost half a billion dollars.
According to the Justice Department, the amount of fraudulent Medicare claims totaled to around $452 million. This was the highest dollar amount to have been found in a single raid in the history of the federal strike force since it began combating Medicare fraud. Arrests were made in seven major cities: Miami, Tampa, Houston, Baton Rouge, Los Angeles, Detroit, and Chicago.
In addition to going after the group of 107 medical professionals who have been charged with committing Medicare fraud, the federal government made use of the technology that allows them to see insurance claims “in real time”. As a result, the federal government either suspended or took other administrative actions against 52 medical providers after taking a close look at their billing requests. The federal government found additional “credible allegations of fraud” when it examined those billing requests.
Assistant Attorney General Lanny Breuer is the head of the Justice Department’s criminal division. He said that “Medicare is an attractive target for criminals”. Perhaps this new takedown of medical professionals who are charged with committing Medicare fraud will make Medicare look like a less attractive target for criminals.
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