National Takedown Targets Medicare Criminals

Medicare Fraud Strike Force operations in seven cities have led to charges against 91 people—including doctors, nurses, and other licensed professionals—for their alleged participation in Medicare fraud schemes involving $429.2 million in false billing. FBI Associate Deputy Director Kevin Perkins joined Attorney General Eric Holder, Health and Human Services Secretary Kathleen Sebelius, and other government officials at a Washington, D.C. press conference announcing the takedown.

The largest number of defendants were charged in Miami—a total of 33 for their alleged participation in various fraud schemes involving a total of $204.5 million in false billings for home health care, mental health services, occupational and physical therapy, and durable medical equipment. Other defendants were charged in Los Angeles (16), Brooklyn (15), Dallas (14), Baton Rouge (4), and Chicago (2).

According to court documents, defendants were charged in schemes to submit claims to Medicare for treatments that were medically unnecessary and often never provided. In many cases, patient recruiters, Medicare beneficiaries, and others were allegedly paid kickbacks in return for supplying beneficiary information to the providers who submitted the fraudulent claims.

Perkins, who called the strike force’s partnerships “a critical piece of our strategy” to “protect the integrity of Medicare and the health care system at large,” also offered steps that the public—especially Medicare and Medicaid beneficiaries and their family members—can take to help prevent fraud:

  • Beware of suspicious activity, including marketers offering money, gifts, or free services to patients;
  • Review explanation of benefits forms sent by your insurance company (and contact your company immediately if you see any suspect billings);
  • Protect your insurance card information the same way you would protect your credit card information;
  • Report any suspicious activity to your local FBI office or HHS’ Office of Inspector General.