Feds arrest 243 in $712m Medicare fraud sting

(Reuters) — The U.S. Justice Dept. said yesterday that 243 people were arrested across the country, charged with submitting fake billing for Medicare, a government healthcare program, that totaled $712 million.

Attorney General Loretta Lynch described the arrests as the largest criminal healthcare fraud takedown in the history of the Justice Dept.

Those arrested included 46 doctors, nurses and other licensed medical professionals. The charges are based on a variety of alleged fraud schemes, the government said, including submitting claims to Medicare and Medicaid, the healthcare program for low-income individuals, for treatments that were medically unnecessary and often never provided.

The nationwide sweep, led by the Medicare Fraud Strike Force and the U.S. Centers for Medicare & Medicaid Services, involved about 900 law enforcement officials. It’s the largest both in terms of the number of those charged and the amount of money lost.

Many of the arrests were in Florida, long an epicenter of Medicare fraud. In Miami, 73 defendants were charged with offenses involving approximately $263 million in false billings.

One mental health facility there billed close to $64 million for psychotherapy sessions that were nothing more than moving patients to different locations, Lynch said in a press conference.

Other cities involved include Houston, Dallas and McAllen, Texas; Los Angeles; Detroit; Tampa; Brooklyn; and New Orleans.

One case in Michigan involved a doctor who prescribed unnecessary narcotics in exchange for patients’ identification information, which was used to generate false billings. Patients then became deeply addicted to the prescription narcotics and were bound to the scheme as long as they wanted to keep their access to the drugs.

“In the days ahead, the Dept. of Justice will continue our focus on preventing wrongdoing and prosecuting those whose criminal activity drives up medical costs and jeopardizes a system that our citizens trust with their lives,” Lynch said.

Since 2007, as part of increased efforts to tackle Medicare fraud, federal authorities have charged nearly 2,100 people with falsely billing the Medicare program more than $6.5 billion, according to the Justice Dept. Yesterday’s arrests bring that total to over 2,300 people who have billed over $7 billion.

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