fraud

Feds charge more than 100 individuals, including doctors, in $452 million Medicare fraud sweep

Tuesday, May 08, 2012 by: Ethan A. Huff, staff writer
Tags: Medicare, fraud, doctors

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(NaturalNews) The government-run healthcare programs Medicare and Medicaid are wrought with fraud, a fact that was once again made apparent in the latest string of busts carried out by the U.S. Department of Justice (DOJ). According to Reuters, 107 individuals -- many of whom are doctors and nurses -- were recently arrested and charged for roughly $452 million worth of Medicare fraud.

These individuals, located all over the United States, allegedly submitted phony claims to Medicare for services that were not administered, laundered money and accepted kickbacks, among other crimes. The nearly half a billion dollars' worth of fraud involved represents the largest amount ever in a single raid, topping an earlier record from back in March (http://www.naturalnews.com/035199_Medicare_fraud_doctors.html).

"These fraud schemes were committed by people up and down the chain of healthcare providers -- from doctors, nurses, and licensed clinical social workers, to office managers and patient recruiters," said Assistant Attorney General Lanny Breuer from the DOJ's Criminal Division.

The U.S. Department of Health and Human Services (HHS) also targeted 52 medical providers for "credible allegations of fraud," according to the Los Angeles Times, and either suspended or took various other administrative actions against them. Collectively, seven cities were represented in the massive sweep, including Los Angeles, Miami, Tampa, Houston, Detroit, Chicago and Baton Rouge.

"Medicare is an attractive target for criminals," added Breuer. "If you don't believe it, ask Lawrence Duran, the former owner of a mental healthcare company in Miami who was sentenced last year to 50 years in prison. Or his two co-owners, each of whom was sentenced to 35 years."

Since 2008, cases of healthcare fraud have nearly doubled, at least as far as identifying such fraud is concerned. Under the Obama Administration, the DOJ has significantly stepped up its efforts to combat healthcare fraud, having charged 1,430 people last year. More than 60,000 Medicare and Medicaid providers and suppliers reportedly lost their licenses in the process, which accounted for the recovery of more than $4 billion in fraudulent claims.

According to the group Coalition Against Insurance Fraud (CAIF), there has already been at least 302 reported cases of Medicare and Medicaid fraud in 2012 thus far. Together with general "medical" fraud, Medicare and Medicaid fraud represent nearly half of all the insurance fraud that has occurred so far this year.

Sources for this article include:

http://www.reuters.com

http://www.latimes.com

http://www.insurancefraud.org/stats.htm

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