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Hundreds Arrested for $900 Million Worth of Health Care Fraud

The Justice Department announced Wednesday it’s charging hundreds of individuals across the country with committing Medicare fraud worth hundreds of millions of dollars.

This is the largest takedown in history, in regards to the number of people charged and the loss amount, according to the Justice Department.

The majority of the cases being prosecuted involve separate fraudulent billings to Medicare, Medicaid or both for treatments that were never provided.

In one case, a Detroit clinic that was actually found to be a front for a narcotics diversion scheme billed Medicare for more than $36 million, the Justice Department said.

The actual numbers:

  • $900 million in false billing
  • $38 million sent from Medicare and Medicaid to one clinic to carry out medically unnecessary treatments
  • $36 million billed to Medicare by a Detroit clinic that was actually a front for a narcotics diversion scheme
  • 1,000 law enforcement personnel involved
  • 301 defendants charged across the United States
  • 61 of those charged are medical professionals
  • 36 federal judicial districts involved
  • 28 of those charged are doctors

A doctor in Texas has been charged with participating in schemes to bill Medicare for “medically unnecessary home health services that were often not provided.”

In Florida, the owner of several infusion clinics is accused by the federal government of defrauding medicare out of over $8 million for a scheme involving the reimbursement for expensive intravenous drugs that were never actually purchased and never given to patients.

The defendants are charged with a numerous crimes, including conspiracy to commit health care fraud, violations of anti-kickback statutes, money laundering and aggravated identity theft.

The Justice Department says that 301 people across the country have been charged with about $900 million in false billing — both records for the Medicare Fraud Strike Force, which carried out the “unprecedented nationwide sweep.”

Defendants in Florida are charged with carrying out more than $200 million worth of fraud, while individuals in California, Texas and Michigan are charged with committing more than $100 million worth of fraud in each state.

Health care fraud and insurance fraud includes the following:

  • Billing insurance providers for healthcare that was not performed
  • Billing for emergency services when they were not provided
  • Falsifying medical records
  • Providing unnecessary procedures
  • Prescribing unnecessary medicines
  • Double billing for work performed

If you are a healthcare provider, or work in the medical field, and are under investigation for or have been arrested or charged with a health care fraud offense, it is important to consult with a Florida Insurance Fraud Defense Lawyer at Whittel & Melton. In addition to prison time, your professional license could be revoked if you are convicted of any wrongdoing. Your career and your freedom all rely on a strong defense against the serious charges stacked against you.

For more information about your Florida Health Care Fraud or Insurance Fraud case, please call us at 866-608-5529 to schedule your free consultation, or contact us online.

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