Nine individuals were charged in Houston for schemes involving $8 million in fraudulent Medicare claims for physical therapy, durable medical equipment, home health care and chiropractor services.
In Dallas, seven defendants were indicted for conspiring to submit $2.8 million in false billing to Medicare related to durable medical equipment and home health care.
Five defendants were charged in Los Angeles for their roles in schemes to defraud Medicare of more than $28 million. The cases in Los Angeles involve false claims for durable medical equipment and home health care.
In Baton Rouge, La., six individuals were charged for a durable medical equipment fraud scheme involving more than $9 million in false claims.
In Chicago, charges were filed against 11 individuals associated with businesses that have billed Medicare more than $6 million for home health, diagnostic testing and prescription drugs.
"Every American bears the burden of health care fraud, and the FBI, in conjunction with our inter-agency partners, will continue to dismantle criminal networks that bilk the system," said Shawn Henry, executive assistant director of the FBI's Criminal, Cyber, Response and Services Branch. "Our agents and analysts use task forces and undercover operations to identify individuals who treat the health care system as a vehicle to line their pockets."
The Department of Human Services estimates that Medicare fraud cost taxpayers more than $24 billion, just in 2009. HHS Inspector General Daniel Levinson told Congress recently that 1,300 investigations in the past year alone have resulted in 500 Medicare fraud convictions, and an estimated $3 billion in recovered funds. Because of the massive scale of the fraud, special Medicare strike forces were created beginning in 2007 to try to stem the flood of taxpayer dollars flowing to illegal operations.
Levinson told Congress, "Health care fraud schemes commonly include billing for services that were not provided or were not medically necessary, purposely billing for a higher level of service than what was provided, misreporting costs or other data to increase payments, paying kickbacks, and/or stealing providers' or beneficiaries' identities."
And, he says, the perpetrators of these schemes range from street criminals, who believe it is safer and more profitable to steal from Medicare than trafficking in illegal drugs, to Fortune 500 companies that pay kickbacks to physicians in return for referrals.