111 health­care providers, oth­ers charged with fraud

Modern Healthcare - - Late News -

Fed­eral authorities charged 111 doc­tors, nurses and other de­fen­dants with health­care fraud in al­leged scams un­cov­ered by Medi­care strike forces, HHS and the U.S. Jus­tice Depart­ment an­nounced. Of­fi­cials said the un­re­lated schemes to­gether were re­spon­si­ble for about $225 mil­lion in fraud­u­lent billing. At­tor­ney Gen­eral Eric Holder and HHS Sec­re­tary Kath­leen Se­be­lius said in a joint news con­fer­ence that the ar­rests in the co­or­di­nated take­down are ev­i­dence that the gov­ern­ment is get­ting more so­phis­ti­cated at iden­ti­fy­ing billing scams that drain re­sources from its health pro­grams. The bulk of the al­le­ga­tions in­volve fraud­u­lent billing for durable med­i­cal equip­ment, phys­i­cal ther­apy and home health, but also claims for proc­tol­ogy and po­di­a­try pro­ce­dures never per­formed. Ar­rests were car­ried out in Ba­ton Rouge, La.; Chicago; Dal­las; Detroit; Hous­ton; Los An­ge­les; Mi­ami; New York; and Tampa, Fla. They fol­low in­dict­ments un­sealed two days ear­lier against an ad­di­tional 20 de­fen­dants in Mi­ami ac­cused of par­tic­i­pat­ing in a $200 mil­lion fraud scheme bro­ken up in Oc­to­ber. HHS and the Jus­tice Depart­ment run the strike forces with the help of state and lo­cal agen­cies, and they have ex­panded the model to sev­eral cities over the past year in or­der to repli­cate suc­cesses with the pro­to­type in Florida and a sec­ond in Los An­ge­les.

“We have iden­ti­fied and shut down large-scale fraud schemes,” At­tor­ney Gen­eral Eric Holder says of the ar­rests.

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