The Justice Department announced that the Medicare Fraud Strike Force arrested 412 individuals from 41 federal districts that defrauded the country's national healthcare program of over $1.3 billion through false billing. Among those arrested were 115 doctors, nurses, and other medical practitioners.
The charges
Those arrested will be accused of forwarding illegal bills to the national health service.
Those arrested illegally billed the U.S Medicaid, Medicare and the Medical insurance programs for veterans, armed force personnel, and their family members. The accused charged these programs medicine that was never purchased by patients. Attorney General Sessions said that "many medical professionals such as doctors, pharmacists, and nurses have chosen to break the law and turn to greed instead of putting patients first." He also said that "some medical professionals had made the scheme a multimillion dollar enterprise at the expense of taxpayers." Secretary Price stated that "the United States has the world's best medical professionals, but their work is always jeopardized by criminals who commit Health Care Fraud."
How the crimes were committed
According to investigators, those arrested submitted claims to Medicare, Medicaid, and TRICARE for unnecessary treatments or treatments that were not provided.
Kickbacks were paid to patient recruiters, beneficiaries and others by healthcare service providers in return for supplying them with beneficiary information. Healthcare providers then submit fraudulent bills to Medicare for unnecessary services or services they never performed.
Examples of the health care fraud incidences
The largest arrest occurred in the Southern District of Florida where 77 people were arrested for defrauding the national healthcare service of over $144 million by falsely billing items in home care, pharmaceutical, and mental health. In one treatment center, the owners recruited patients, moved them to South Florida and illegally billed insurance companies for testings and medical procedures they never performed.
Patients were given kickbacks such as gift cards, drugs, free airline tickets, trips to casinos and strip clubs.
In another incident, $218 million was fraudulently acquired through false claims. 32 defendants were arrested in the Eastern District of Michigan after submitting false applications for services they did not perform.
In yet another incident, 15 individuals were arrested for fraudulently billing Medicare for home health services of over $7 million in services not rendered or were unnecessary. Those detained in this case will also be charged with giving kickbacks, mail fraud and wire fraud.