Medicare fraud happens when Medicare is billed for services or supplies you never received. Medicare fraud costs Medicare a great deal of money each year. Medicare abuse is when doctors or suppliers do not follow good medical practices, which leads to unnecessary costs to Medicare, improper payment, or services that are not medically necessary.
A nationwide takedown by the Medicare Fraud Strike Force operations has been rampant. On May 14, 2013 Attorney General Eric Holder and Department of Health and Human Services Secretary Kathleen Sebelius announced that an operation conducted in eight states had resulted in charges against 89 individuals, including doctors, nurses and other licensed medical professionals.
These individuals were alleged to have participated in Medicare fraud schemes involving approximately $223 million in false billings. The coordinated task force, which included the FBI, Health and Human Services Office of Inspector General (HHS-OIG), Director of Centers for Medicare and Medicaid Services (CMS) Center for Program Integrity, was the sixth national Medicare fraud takedown in Strike Force History.
In total, almost 600 individuals have been charged in connection with schemes involving almost $2 billion in fraudulent billings. There is a clear awareness and mandate that Medicare fraud will be heavily investigated and prosecuted, both in the federal and state levels.
Since their inception in March 2007, Strike Force operations in nine locations have charged more than 1,500 defendants who have falsely billed the Medicare program for more than $5 billion. In addition, CMS working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
The joint Department of Justice and HHS Medicare Fraud Strike Force is a multi-agency team of federal, state and local investigators designed to combat Medicare fraud through the use of Medicare data analysis techniques and increased focus on community policing.
Attorney General Holder in a press release stated that, “today’s announcement marks the latest step forward in our comprehensive efforts to combat fraud and abuse in our health-care systems. They are helping to deter would-be-criminals from engaging in fraudulent activities in the first place.” HHS Secretary also added that, “the Affordable Care Act has given us additional tools to preserve Medicare and protect the tens of millions of Americans who rely on it each day.”
The federal government from the “top” has committed its resources and focus on expanding their authority to suspend Medicare payments and reimbursements when fraud is suspected. Today, the federal government along with state and local agencies is sending a strong, clear message that those who seek to defraud Medicare will get caught and pay the price.
As recent as September 25, 2013, five Miami residents were arrested in a $48 million home health Medicare fraud. As I stated above, Medicare fraud and arrest are no longer uncommon but becoming regular news. As such, if you are arrested for allegedly committing this crime, it is critically important to seek legal representation. I am in the midst of representing clients who are both being prosecuted in federal and state courts so immediately call my office if you have been arrested or requested to speak to law enforcement about allegations of Medicare fraud.
Any questions, feel free to contact my office at (310) 601-7144 or email me at [email protected].