Feds Indict 91 in Medicare Fraud Sweep: Allege $430 Million Loss

Posted By Law Offices of Jeffrey C. Grass || 4-Oct-2012

President Obama is working hard to cut Medicare costs without cutting benefits. To achieve this goal, the Administration has launched the Medicare Fraud Strike Force. Following a successful initial sweep in May, a second investigation by the force has led to the indictment of 91 individuals on various Medicare fraud charges.

The majority of the individuals charged were health care professionals predominantly from Texas, Florida and California. According the Justice Department, the alleged healthcare fraud took many forms including:

In addition to the fraud indictments, some of the suspects are facing other charges, including identity theft and money laundering. The government has already seized over $4.6 million in assets in conjunction with this operation.

In contrast to the first raid, the second group of defendants is comprised mostly smaller organizations whom the Justice Department believes were trying to fly under the radar while fleecing Medicare and Medicaid programs.

Not all of the operators were small. Riverside General Hospital in Houston is accused of filing $42 million in bad claims. This number is in addition to the $116 million the hospital was previously accused off billing improperly.

Fraud Claims Not Always What They Seem

The government claims new technology is helping them ferret out Medicare and Medicaid fraud more efficiently. Authorities are using new software to scan Medicare and Medicaid claims for potential irregularities and inconsistencies. Investigations into these anomalies has led to many of the fraud charges.

In the healthcare field in particular, fraud is not always clear cut. What may appear to be fraud may actually be an error on behalf of healthcare staff. Both the Medicare and Medicaid have extremely complex billing systems that frequently lead to billing problems. Common mistakes include billing code errors, duplicate invoices and unbundling.

Our law firm handles many different kinds of fraud claims like those mentioned above. For more information, please visit our Plano Medicare fraud page.

Source: www.reuters.com, "Authorities charge 91 in $430 million Medicare fraud," David Ingram and David Morgan, 4 October 2012