More Than 90 Charged in Huge Medicare-Fraud Scheme

The federal government is aggressively cracking down on healthcare fraud. U.S. Attorney General Eric Holder recently announced a major Medicare-fraud bust — one of the largest takedowns of a healthcare fraud scheme ever.  Charges were brought against more than 90 people, including doctors and nurses, in seven cities for their alleged part in the scheme that totaled nearly $430 million in billings for treatment and services that were not medically necessary or were never provided.

The scale of the fraud is staggering.  For example, just three people — a doctor and two nurses — allegedly wrote over 30,000 prescriptions, with a fraudulent value of $100 million.

This was the fifth major enforcement action since the Health Care Fraud Prevention and Enforcement Action Team (HEAT) came on the scene in 2009.  The current Administration has made it a top priority to prevent and stop Medicare fraud. “Through HEAT,” Holder said, “we’re taking this fight to a new level.” The Department of Justice and Health and Human Services are also running Medicare Fraud Task Forces in nine cities.

Holder praised the many investigators, prosecutors, law enforcement officers and other involved in stopping the scheme. “[T]heir dedication to this work,” he said, “is sending a clear message to those willing or attempting to commit health care fraud: that we will use every available tool and resource to find you, to stop you, and to punish you to the fullest extent of the law.”

WeComply’s one-hour Medicare compliance training covers employee responsibilities, types of fraud, essential aspects of the Centers for Medicare & Medicaid Services’ (CMS) compliance plan, and other key aspects of preventing and reporting Medicare fraud.

Categories: Healthcare
Tags: Medicare Fraud