Federal officials cracked down on medical establishments today, when they charged 91 people in seven cities (Baton Rouge, Louisiana, Chicago, Dallas, Houston, Los Angeles, Miami and New York City) for approximately $430 million in Medicare fraud. The investigation conducted by the Justice Department and the Health and Human Services department uprooted many false billing schemes in the Medicare program, which allocates $590 billion to helping the elderly and disabled.
The indictments total more than $230 million in home health care fraud, $100 million in mental health care fraud, and $49 million in ambulance transportation frauds. Though this bunch is just a small portion of the doctors, nurses, and healthcare administrators who help heal sick people, the accused make the healthcare industry seem like a cartel. Below we list the most egregious of the Medicare frauds charged in this crackdown by city.
Four people, including a registered practical nurse, billed Medicare $2.4 million over the sale of medically unnecessary equipment.
A psychologist was charged with sending thousands of false claims for services to Medicare recipients in nursing homes. According to the indictment, she claimed that she had provided psychotherapy services to patients who had long been dead. Multiple times, she reported that she had provided over 24 hours of care in a single day.
One scheme in Dallas, involving just one medical doctor and two registered nurses, defrauded the Medicare program to the tune of $100 million in home health care services, amounting to nearly half of the home health care fraud charged in this strike. The indictment says that the doctor billed Medicare for 33,000 prescriptions allotted to 2,000 patients (or nearly 17 prescriptions per patient) between 2006 and 2011. Many of the Medicare beneficiaries had primary care physicians who never certified that the company could provide care for them. Allegedly, the doctor would send out so many prescription claims that he would simply sign stacks without reading them.
Seven people in one hospital were charged in today's indictment. The hospital has a troubled legal history and earlier this year, their assistant administrator, Mohammad Kahn, pleaded guilty to conspiracy to commit healthcare fraud and paying kickbacks. Kahn appeared in court for the crimes on February 22, and the charges amounted to $116 million in fraudulent claims sent to Medicare. Today, the federal government tacked on $42 million in claims that were discovered after his previous appearance in court. The kickbacks? Cigarettes, coupons and food given to Medicare recipients, who would watch television or play games rather than receiving the services that were charged to Medicare.
An ambulance company in Los Angeles gets a medal because its ambulance fraud case, at $49.2 million, was the largest ever prosecuted by the Medicare Fraud Strike Force. The court documents say that they billed Medicare for ambulance rides that were medically unnecessary.
Lanny A. Breuer, an Assistant Attorney General for the Justice Department, said in today's press conference that a psychiatric hospital in Miami gave kickbacks in cash to the owners of assisted living facilities in order to obtain more patients. The psychiatric hospital then billed Medicare over $67 million, either for patients that they had never had or for services that they had never performed.
New York City:
The office manager of a Queens medical center and the owner of a service that provides ambulettes, which are transportation to mentally or physically impaired people, charged Medicare $3 million. They reportedly said that they gave physical therapy and diagnostic exams to beneficiaries who were paid in kickbacks to use their services.
Published by Medicaldaily.com