WASHINGTON — Law enforcement authorities announced the arrests Tuesday of 90 people, including 16 doctors, linked to alleged Medicare fraud schemes across the nation involving an estimated $260 million in false billings to the taxpayer-funded program.
Much of the enforcement action was centered in Miami, where 50 people were charged with fraudulent billings for home health care, mental health and pharmacy services worth an estimated $65.5 million.
In one of the Miami cases, two suspects were charged in a $23 million scheme in which the defendants solicited kickbacks from a pharmacy owner for providing Medicare beneficiary information. That data was then used to bill for drugs that were never dispensed.
"The crimes charged represent the face of health care fraud today,'' Acting Assistant Attorney General David O'Neil said. "Doctors billing for services that were never rendered, supply companies providing motorized wheelchairs that were never needed, recruiters paying kickbacks to get Medicare billing numbers of patients.
"The fraud was rampant, it was brazen and it permeated every part of the Medicare system,'' he said.
The enforcement action was the seventh such sweep involving the government's Medicare Fraud Strike Force since 2009. The unit was formed by the Justice Department and the Department of Health and Human Services.
"Medicare is a sacred compact with our nation's seniors, and to protect it, we must remain aggressive in combating fraud,'' Attorney General Eric Holder said, adding that the arrests were necessary to "ensure the integrity of essential health care programs.''
Said HHS Secretary Kathleen Sebelius: "Today, we're sending a strong, clear message to anyone seeking to defraud Medicare. You will get caught and you will pay the price ...''
Of the 16 doctors involved in the suspected fraud, five were Houston-area physicians accused in a conspiracy to bill for "medically unnecessary'' home health services.
In Los Angeles, one doctor was charged with $24 million in Medicare losses related to fraudulent billings and referrals for medical equipment, including 1,000 wheelchairs that also were not medically necessary and "frequently not provided.''
Multiple arrests also were made in Detroit, Brooklyn and Tampa.
In one of the Tampa-based investigations, five people were charged in an alleged money laundering operation in which bills were submitted using the names of Miami-area beneficiaries for services reportedly provided nearly 300 miles away in Tampa-area clinics.
In Brooklyn, Dr. Syed I. Ahmed allegedly submitted $85 million in bills to Medicare over three years, from January 2011 to December 2013 for surgeries that never occurred, according to court documents. Nearly $27 million was submitted to Medicare in 2012 alone.
Source: National Insurance Crime Bureau.
