Medicare strike force charges 111 people for false billing

In addition, HIPAA violations trigger millions in penalties for two large entities.

Last month, the Medicare Fraud Strike Force completed the biggest ever federal health care fraud charging 111 people in nine cities for schemes involving over $225 in fraudulent billing, an HHS news release noted.

The defendants included a variety of health care professionals, from physicians to nurses to therapists. The charges were based on a number of medical treatments and services, including home health care, physical and occupational therapy, nerve conduction tests and durable medical equipment (DME).

The defendants charged in the strike participated in schemes to submit claims to Medicare for treatments that were medically necessary and many a time, never provided. For instance, 10 people in Brooklyn were charged with $90 million in false billings for physical therapy, proctology services, and nerve conduction testing while another 11 people were charged in Chicago for billing Medicare over $6 million in diagnostic testing, home health, and prescription drug false claims.

According to Daniel R Levinson, HHS Inspector General, more than 300 special agents from OIG, in partnership with federal and state agencies across the country made arrests on charges of health care fraud. “These unprecedented operations send a clear message – we’ll not tolerate criminals lining their pockets at the expense of Medicare patients and taxpayers,” said Levinson.

Additionally, agents also executed 16 search warrants throughout the country in connection with the strike force investigations, thus helping to protect the country’s most essential health care programs, Medicare and Medicaid.