On Thursday, the Medicare Fraud Strike Force -- established by HHS and the Department of Justice -- announced that 91 individuals in seven cities have been charged with alleged fraudulent billing totaling an estimated $429 million, Modern Healthcare reports (Carlson, Modern Healthcare, 10/4).
Details of Charges
The individuals -- who included the president of a hospital and numerous physicians and nurses -- were located in Baton Rouge, La., Brooklyn, N.Y., Chicago, Dallas, Houston, Los Angeles and Miami, according to the AP/Sacramento Bee.
U.S. Attorney General Eric Holder, during a news conference, said the crackdown is another example of a growing trend of individuals attempting to steal billions in taxpayer dollars for personal gain. HHS Secretary Kathleen Sebelius added that the department also used its new authority under the Affordable Care Act to halt all future payments to providers who are suspected of fraud (Yost, AP/Sacramento Bee, 10/4).
Details of Billing Charges
According to a DOJ news release, the false billing charges included reimbursements for:
- Home health care, which totaled $230 million;
- Mental health services, which totaled $100 million; and
- Ambulance transportation fraud, which totaled $49 million (Modern Healthcare, 10/4).
The individuals face allegations of:
- Writing prescriptions for patients who did not qualify for them;
- Paying for kickbacks, such as food and cigarettes, to patients who attended programs that hospitals could later bill Medicare for;
- Identity theft; and
- Money laundering (Ingram/Morgan, Reuters, 10/4).