Federal officials have charged 107 suspects with submitting $452 million in false bills to Medicare in seven U.S. cities, says the Miami Herald. In the Miami area, 59 of those defendants were accused of trying to steal $137 million from the taxpayer-funded healthcare program. The takedown — one for the record books since the Justice Department began targeting Medicare corruption as a national crisis in 2007 — was both a surgical and symbolic strike against the still-viral crime.
Not surprisingly, “South Florida has the lion’s share of the cases,” U.S. Attorney Wifredo Ferrer told reporters after 22 indictments were unsealed in Miami federal court. Ferrer said Medicare fraud scammers have evolved from old-fashioned medical equipment suppliers to mental health, physical therapy, home care and HIV service providers. “They all share one thing — greed,” Ferrer said, treating Medicare like an “ATM machine.” Although Medicare has devoted hundreds of millions of dollars to fight fraud with upgraded computer software, the federal program for seniors and the disabled still pays most claims within 30 days. As a result, Medicare’s contractors pay out billions of dollars yearly on fraudulent bills because they fail to detect anything suspicious. Miami, long-recognized as the nation’s capital for Medicare fraud, runs no risk of losing that dubious distinction.
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Federal officials filed charges in the largest health care fraud scam in the nation's history, indicting a Dallas-area physician for purportedly bilking...
Read full entry »About 36 percent of the almost $16 billion recovered by the Justice Department in health care whistle-blower fraud cases has come since 2009, reports USA...
Read full entry »The Justice Department says it has logged a record year in health care fraud recoveries, with investigations yielding $4.1 billion in returned money...
Read full entry »As the Obama administration cranked up efforts this week to find and eliminate billions of dollars in faulty Medicare and Medicaid payments, a review of court cases shows that Tennessee has been home to several fraud schemes , The Tennessean reports. Some cases involve clearly egregious behavior. A typical example is a person who jumps from location to location, steals doctors’ provider identification numbers and bills the federal health programs for services that are never provided. Other times, prosecutions involve seemingly well-intentioned people who make bad, and illegal, decisions.
Glenesha Bowling-Moye and Tabitha Jones were sentenced to 18 and 12 months imprisonment, respectively, on federal health-care fraud and money-laundering charges. They had pleaded guilty to conspiring to defraud Medicare and TennCare of $1.1 million. The two started a business called EBC Healthcare in 2006. The business provided much-needed services to the elderly in some of Nashville’s poorest neighborhoods, from cleaning houses to driving people to medical appointments and Walmart. The problem: They billed Medicare and TennCare for psychotherapy sessions and nurse practitioner home visits but were not providing those professional services. “The key is Medicare doesn’t pay for (cleaning and running errands), period,” said one investigator.
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By Julia Dahl
A new book on health care fraud paints a grim picture of a crime that affects us all, and usually goes undetected.
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Since May 2009, a joint collaboration between the Department of Justice and the Department of Health and Human Services ...
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