243 arrests made in historic healthcare fraud crackdown

As part of a nationwide crackdown on healthcare fraud, federal officials arrested 243 people last week for allegedly participating in schemes that involved approximately $712 million in false billings to Medicare and Medicaid. The arrests included 46 doctors, nurses and other licensed medical professionals.

According to Attorney General Loretta E. Lynch, who announced the arrests alongside HHS Secretary Sylvia Mathews Burwell, the sweep is without precedent.

“This action represents the largest criminal health care fraud takedown in the history of the Department of Justice, and it adds to an already remarkable record of enforcement,” Lynch said in an official statement. “The defendants charged include doctors, patient recruiters, home health care providers, pharmacy owners and others.  They billed for equipment that wasn’t provided, for care that wasn’t needed, and for services that weren’t rendered.”

The Medicare Fraud Strike Force led the operation, which was the result of a large-scale collaboration between the Department of Justice, FBI, Internal Revenue Service Criminal Investigations Division, and Medicaid Fraud Control Units (MFCUs) from 11 states. The strike force primarily focused on fraud related to Medicare Part D prescription drugs, Medicaid Personal Care Services, and Medicare home health benefits.

Arrests were made in a 14 states, ranging from Alaska to Florida. Officials from those states joined federal officials in condemning the alleged fraud.

“When you charge for a medical procedure you never performed, for something a patient never needed or asked for and steal millions from our taxpayers, we are coming after you,” Pam Bondi, Florida attorney general, said in a statement. In southern Florida alone, 73 people were arrested as a part of the investigation.

John R. Parker, acting U.S. attorney of the northern district of Texas, commented on the seven arrests made in his district, which included two physicians and a registered nurse.

“This district will continue to focus all the tools and resources of the Medicare Fraud Strike Force on those who cheat not only Medicare and Medicaid, but all taxpayers and vulnerable patients as well,” Parker said in a statement. “When these schemes are uncovered, and they will be, this office will not hesitate to bring indictments, such as the two that were unsealed this week in Dallas, against those who defraud these essential health care programs.”

Healthcare fraud is believed to cost the United States $60 to $90 billion per year. To help fight the rampant fraud, the Affordable Care Act (ACA) included a provision that provided the government with $350 million to acquire new tools and resources—including improved information technology—over a ten-year span. The ACA also called for an increase in screening and background checks and created new, stricter penalties for those who are found guilty of fraud.