Medicare Fraud

Every year, we lose billions of dollars to fraud in federal and state health care programs. Every dollar we lose to fraud and abuse is a dollar that is not available to provide home care to seniors, to treat HIV and AIDS, to immunize children, and to discover new treatments for cancer and other diseases. Some fraud schemes even pose a direct threat to the health and safety of patients. Many instances of health care fraud sug­gest that existing control systems do not work the way we imagine they should. Often the manner in which schemes are revealed suggests detection is more luck than system. Whistleblower lawsuits have exposed billing by health care providers for services not rendered, billing for products not delivered, misrepresenting services, unbundling services, billing for medically unnecessary services, duplicate billing, increasing units of service which are subject to a payment rate, falsifying cost reports resulting in increased payment to the health care provider, kickbacks, and on and on. Healthcare fraud is still going strong and this blog is intended to keep readers up to date with all healthcare fraud related news and to provide commentary when warranted. This blog also contains an array of laws and regulations concerning healthcare fraud set out in an easy to read format.

Medicare Fraud Strike Force Charges 30 Individuals with Medicare Fraud and Expands Operations

by Nolan and Auerbach on January 12, 2010

Thanks to the Medicare Fraud Strike Force, 30 people have been charged in three cities for their alleged roles in schemes to submit more than $61 million in false Medicare claims, according to a Dec. 15, 2009 press release by the Federal Bureau of Investigation (FBI). These individuals who were charged are accused of various Medicare fraud crimes, including conspiracy to defraud the Medicare program, conspiracy to launder money, money laundering, criminal false claims, making false statements, and receiving kickbacks, according to the release.

On the same day of the release, the Department of Justice and U.S. Department of Health and Human Services announced the expansion of Strike Force operations into Brooklyn, Tampa, and Baton Rouge.  Strike Force teams are operating in seven cities: Miami, Los Angeles, Detroit, Houston, Brooklyn, Tampa, and Baton Rouge.

The Strike Force has obtained indictments of more than 460 individuals and organizations that collectively have falsely billed the Medicare program for more than one billion dollars, according to the release.

For the full release, go to: http://www.fbi.gov/pressrel/pressrel09/medicare_121509.htm.

For more information about qui tam law and health care fraud, contact Nolan and Auerbach, PA.

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