Relias Media - Continuing Medical Education Publishing

The trusted source for

healthcare information and

CONTINUING EDUCATION.

  • Sign In
  • Sign Out
  • MyAHC
    • Home
      • Home
      • Newsletters
      • Blogs
      • Archives
      • CME/CE Map
      • Shop
    • Emergency
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • Hospital
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • Clinical
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • All Access
      • Subscribe Now
      • My Subscription
    • My Account
      • My Subscriptions
      • My Content
      • My Orders
      • My CME/CE
      • My Transcript
    Home » 243 people arrested for $712 million in false billing

    243 people arrested for $712 million in false billing

    August 1, 2015
    No Comments
    Reprints
    Facebook Twitter Linkedin Share Share

    Related Articles

    National Fraud Takedown Nets 301 People And $900 Million in False Billing

    Hospital agrees to pay $89 million in False Claims Act settlement

    Allina settles false claims case for $16 million

    Related Products

    243 people arrested for $712 million in false billing

    National Fraud Takedown Nets 301 People And $900 Million in False Billing

    Hospital to pay $9.5 million for Medicare billing issues | Single Article

    In a case involving the most defendants charged and largest alleged loss amount in the history of the federal fraud task force, a nationwide sweep has led to charges against 243 individuals, including 46 doctors, nurses, and other licensed medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $712 million in false billings.

    Department of Health and Human Services (HHS) Secretary Sylvia M. Burwell and Attorney General Loretta E. Lynch announced the charges. In addition, the Centers for Medicare & Medicaid Services also suspended several providers using its suspension authority as provided in the Affordable Care Act.

    The defendants are charged with various healthcare fraud-related crimes, including conspiracy to commit healthcare fraud, violations of the anti-kickback statutes, money laundering, and aggravated identity theft. The charges are based on alleged fraud schemes involving medical treatments and services, including home health care, psychotherapy, physical and occupational therapy, durable medical equipment, and pharmacy fraud. More than 44 of the defendants arrested are charged with fraud related to the Medicare prescription drug benefit program known as Part D, which is the fastest-growing component of the Medicare program overall.

    According to court documents, the defendants participated in alleged schemes to submit claims to Medicare and Medicaid for treatments that were medically unnecessary and often never provided. In many cases, patient recruiters, Medicare beneficiaries, and other co-conspirators allegedly were paid cash kickbacks in return for supplying beneficiary information to providers, so that the providers could submit fraudulent bills to Medicare for services that were medically unnecessary or never performed.

    “Every day, the Criminal Division is more strategic in our approach to prosecuting Medicare fraud,” said Assistant Attorney General Leslie R. Caldwell, JD, of the Justice Department’s Criminal Division. “We obtain and analyze billing data in real time. We target hotspots — areas of the country and the types of healthcare services where the billing data shows the potential for a high volume of fraud — and we are speeding up our investigations. By doing this, we are increasingly able to stop schemes at the developmental stage and to prevent them from spreading to other parts of the country.”

    The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. Strike Force operations in nine locations have charged more than 2,300 defendants who collectively have falsely billed the Medicare program for more than $7 billion.

    Post a comment to this article

    Report Abusive Comment

    www.reliasmedia.com

    Healthcare Risk Management

    View PDF
    Healthcare Risk Management 2015-08-01
    August 1, 2015

    Table Of Contents

    When does a hospital’s apology switch to being manipulation?

    Warning! The Phone has Ears

    Anesthesiologist ordered to pay $500,000 after patient’s smartphone records insults

    Revamped RRT and early warning system improves safety at pediatric hospital

    RCAs become RCA2s under new NPSF guidelines

    Never events usually are traced to multiple human factors, not just a root cause

    OSHA promises closer scrutiny of staff injuries

    243 people arrested for $712 million in false billing

    Study: Aggressive med mal increases LOS and costs

    Hospitals sued over claims they limited marketing

    Failure to update a patient’s EHRs leads to $35.4 million verdict against hospital

    Decision not to operate on 2-year-old results in death and $6.25 million jury award

    Begin Test

    Buy this Issue/Course

    Shop Now: Search Products

    • Subscription Publications
    • Books & Study Guides
    • Webinars
    • Group & Site
      Licenses
    • State CME/CE
      Requirements

    Webinars And Events

    View All Events
    • Home
      • Home
      • Newsletters
      • Blogs
      • Archives
      • CME/CE Map
      • Shop
    • Emergency
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • Hospital
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • Clinical
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • All Access
      • Subscribe Now
      • My Subscription
    • My Account
      • My Subscriptions
      • My Content
      • My Orders
      • My CME/CE
      • My Transcript
    • Help
    • Search
    • About Us
    • Sign In
    • Register
    Relias Media - Continuing Medical Education Publishing

    The trusted source for

    healthcare information and

    CONTINUING EDUCATION.

    Customer Service

    customerservice@reliasmedia.com

    U.S. and Canada: 1-800-688-2421

    International +1-404-262-5476

    Accounts Receivable

    1-800-370-9210
    ReliasMedia_AR@reliasmedia.com

    Mailing Address

    • 1010 Sync St., Suite 100
      Morrisville, NC 27560-5468
      USA

    © 2020 Relias. All rights reserved.

    Do Not Sell My Personal Information  Privacy Policy  Terms of Use  Contact Us  Reprints  Group Sales

    For DSR inquiries or complaints, please reach out to Wes Vaux, Data Privacy Officer, DPO@relias.com

    Design, CMS, Hosting & Web Development :: ePublishing