Doctors and nurses were among 94 people charged Friday for filing nearly 4,000 false Medicare claims totaling $251 million. This massive Medicare scam bust was carried out in NYC, Miami, Detroit, Houston and Baton Rouge.
Considered the largest takedown in history, the arrests were part of a massive overhaul in which federal officials are trying to preventing and prosecuting the crimes.
These arrests represent a small fraction of the estimated $60 billion to $90 billion in Medicare fraud absorbed by taxpayers each year.
Under Obama's Affordable Care Act, there is now more power afforded to authorities to stop paying providers who file fraudulent claims.
"That world is coming to an end," Health and Human Services Secretary Kathleen Sebelius told The Associated Press after speaking at a health care fraud prevention summit in Miami. "We've got new ways to go after folks that we've never had before."
A new joint effort by HHS and the Department of Justice enables law enforcement to view Medicare claims in real time and flag suspicious patterns.
According to the AP, in one $72 million scam at Bay Medical in Brooklyn, clinic owners submitted bogus physical therapy claims for elderly Russian immigrants.
Miami is also a big area for Medicare scams. Authorities indicted 33 suspects in the Miami area, accused of charging Medicare for about $140 million in various scams.
Wiretaps captured hundreds of kickback payments given to patients and even given to undercover agents. Many were given $50 to $100 a visit in exchange for using their Medicare numbers and got bonuses for recruiting new patients.
Hopefully more stringent rules including background checks, will help when it comes to reducing the number of medical providers who can become a Medicare provider. Under new laws, a moratorium can be applied to new applications in certain areas, like physical therapy, if they notice a spike in fraudulent activities.
Photo: Assistant Attorney General Lanny Breuer, left, speaks to the media as Loretta Lynch, center, U.S. Attorney for the Eastern District of New York, and other law enforcement officials announce charges against doctors, health care company owners, executives and others in a case of alleged false medicare billing. (AP Photo/Robert Mecea)
Source: AP
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Talk about a can of worms! "Health Professionals" or rather Insurance Acceptors, seemingly dance this same dance - I hope the government finally locks up all the crooks in White coats with degrees they are having to pay back with the insurance money they scam - that'll be a good step towards real "Health Care." But before they do, they need to legalize pot to free up some space in the prisons and provide the people with a natural way to relax and take care of their pains. DHC - I'd tune in for this show every day!
Wonderful info Cheryl--years ago when I worked for a carrier the unit I was attached to did various types of review to catch fraud, and saw similar things to this. And the general public doesn't know. As I tell my clients, it's not only the insurance companies that are in this for the money. The schemes run rampant, yet the public doesn't get why carriers feel a need to scrutinize certain things. Sure they go overboard sometimes, but check out something like this, and you know why.
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