Arrests in the Southern District of
Florida resulted from a big sting
United States Attorneys and the head of Medicare have announced the results of a multi-agency effort to prosecute individuals and health care companies that fraudulently bill the Medicare program. On May 8, 2007, the U.S. Attorney's Office charged 24 individuals with Medicare fraud. Four additional individuals were arrested in a separate health care fraud scheme. This brings the total number of defendants charged to date to 42.
The arrests in the Southern District of Florida are the result of the establishment of a multi-agency task force of federal, state and local investigators designed specifically to combat Medicare fraud through the use of real-time analysis of Medicare billing data. Since the first phase of strike force operations began on March 1, 2007 in Southern Florida, the strike force has indicted 34 cases that have collectively billed the Medicare program for $142,061,059. Charges brought against the thirty-eight defendants include conspiracy to defraud the Medicare program, criminal false claims, and violations of the anti-kickback statutes. If convicted, many of the defendants face up to 20 years in prison on these charges.
The strike force is able to identify potential fraud cases for investigation and prosecution quickly through real-time analysis of billing data from Medicare Program Safeguard Contractors (PSCs) and claims data extracted from the Health Care Information System. In phase one operations in Miami, 34 fraud indictments have been returned against infusion therapy and durable medical equipment (DME) suppliers.
The work of the Medicare fraud strike force is one step in a multi-phase enforcement and regulatory project designed to improve the quality of the industry and reduce the potential for fraud in the durable medical equipment and infusion areas. The Centers for Medicare and Medicaid Services is taking steps to increase accountability and decrease the presence of fraudulent providers. The end result will be better service to beneficiaries and savings of billions of dollars that might otherwise go to fraudulent businesses.
According to Acosta, the Strike Force is supplementing the ongoing health care fraud enforcement efforts of the United States Attorney's Office in the Southern District of Florida, which has been among the leading offices in combating health care fraud nationwide. Since announcing a federal-state health care fraud initiative in December 2005, the United States Attorney's Office has filed more than 130 criminal cases charging nearly 200 defendants with federal violations in various health care fraud schemes and significant civil cases, enforcement actions, and settlements. Collectively, defendants and subjects billed the Medicare program $300 million and received more than $150 million in reimbursements in cases that preceded the Strike Force prosecutions announced today. The vast majority of these cases involved fraudulent DME or HIV infusion fraud schemes.
