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June 20, 2013

Medicare Fraud Strike Force Charges 111 in Fraud Schemes Totaling $225 Million and Expands to Chicago and Dallas

The Medicare Fraud Strike Force indicted 111 defendants for their alleged participation in Medicare fraud schemes totaling more than $225 million in false billing. The announcement came from the Department of Justice (DOJ) and Department of Health & Human Services (HHS) after charges were filed against the defendant physicians, nurses, health care company owners, and executives, for a variety of crimes including conspiracy to defraud the Medicare program, criminal false claims, anti-kickback statute violations, money laundering, and aggravated identity theft.

According to the joint DOJ and HHS press release, the defendants participated in schemes to submit claims for medically unnecessary treatments or treatments that were never provided. In exchange for kickbacks, the defendants also allegedly provided beneficiary information to providers who submitted fraudulent billing to Medicare. The February 17 operation is “the largest-ever federal health care fraud takedown,” according to the DOJ/HHS. The defendants are located across the country, including cities in Florida, Michigan, New York, Texas, California, Louisiana, Illinois, and Texas.

In addition to the charges, the DOJ and HHS announced an expansion of the Strike Force to Chicago and Dallas. The Medicare Fraud Strike Force is a multi-agency team of federal, state, and local investigators. The Strike Force is part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT) charged with preventing and deterring fraud and enforcing current anti-fraud laws. Since their 2007 inception, Strike Force teams have charged more than 990 people for false Medicare billing practices totaling more than $2.3 billion.

©2013 von Briesen & Roper, s.c

About the Author

Meghan O’Connor is a member of the Health Care Practice Group. Her practice focuses on general health law including managed care and provider contracting, risk management, and regulatory compliance.

Prior to joining von Briesen, Meghan worked for the Centers for Medicare and Medicaid Services where she consulted with states regarding federal health law, regulation and policy, evaluating managed care contracts and conducting compliance reviews.

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