On June 18, Federal officials announced criminal enforcement actions against 243 individuals across the country. The nationwide arrests mark the largest criminal health care fraud takedown in history and came as a result of Medicare Fraud Strike Force investigations. The Attorney General, HHS Secretary, and FBI Director announced the charges, which allege various health care fraud-related crimes, including conspiracy to commit health care fraud, violations of the anti-kickback statutes, money laundering, and aggravated identity theft. According to the government, these individuals are accused of generating a total of $712 million in fraudulent billings.
The allegations address a broad range of fraudulent conduct, including billing Medicare and Medicaid for unnecessary services or for services not rendered, and billing for equipment never provided. Several of the indictments allege that providers made cash payments to “patient recruiters” in exchange for making patient referrals. In addition, a large fraction of the individuals are charged with conduct relating to Medicare Part D, the outpatient prescription drug coverage program.
These charges originate primarily in jurisdictions previously targeted by the Strike Force—Miami, Houston, Dallas, Los Angeles, Detroit, Tampa, and Brooklyn—while several of the indictments are from non-Strike Force jurisdictions, including McAllen, Texas, New Orleans, and the Southern District of Illinois.
As noted in the DOJ’s press release, this crackdown was funded, at least in part, by $350 million authorized in the Affordable Care Act for health care fraud and enforcement efforts. According to DOJ, it recovers $8 for every $1 spent on Health Care Fraud Abuse and Contract Act programs. Since 2007, the Strike Force operations have charged more than 2,300 individuals with more than $7 billion in fraudulent billings.
Court documents for some of these cases have been posted here.
