Medicare fraud sting results in 91 arrests nationwide

WASHINGTON -- Federal investigators announced Wednesday they charged 91 people in eight cities with attempting to bilk Medicare out of $295 million in what Attorney General Eric Holder called the biggest takedown in Medicare task force history.

The cases in the coordinated nationwide strike consisted of billing for services never provided, money laundering, providing kickbacks for Medicare beneficiary numbers, and, in one case, threatening Medicare recipients that they would lose their housing if they did not participate in a scheme in Miami. More than 400 agencies participated in the sting.

"Our anti-health-care-fraud efforts have never been more innovative, collaborative, aggressive or effective," Holder said. "We are fighting back."

Details from the strike include:

•Forty-five defendants charged in Miami for $159 million in false billings for home health care, mental health services, durable medical equipment (such as electric wheelchairs), physical therapy and HIV infusion. In one case, the owners of a home health care business paid patients kickbacks to say they had received care that had not, in fact, been provided, according to the government.

•Two people charged in Houston for $62 million in false billings for home health care and durable medical equipment. One defendant sold beneficiary information to home health agencies, who then used it to bill Medicare for services the government said they did not provide.

The new cases fall in line with an overall increase in federal health care fraud prosecutions reported by USA TODAY last week: Ramped-up efforts by the Obama administration put health care fraud prosecutions on pace so far this year to rise 85% over last year.

Health and Human Services Secretary Kathleen Sebelius called the charges another benefit of last year's health care law, which created "one of the strongest anti-fraud laws in history."

The law created longer prison terms for health fraud, beefed up the strike force teams, and provided funding for new technology that allows investigators to see claims in real time so they can look for patterns before the bills are paid, she said.

Durable medical equipment and home health care still lead the list for fraud, Sebelius said.

Assistant Attorney General Lanny Breuer said some of the accused were particularly greedy: A Detroit doctor billed for providing psychotherapy treatments for more than 24 hours a day, as well as for treating dead patients. In Miami, the owner of a halfway house threatened to evict her residents if they did not attend mental health sessions at a community center — whether they needed them or not.