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Authorities Arrest 243 People in $712 Million Medicare Fraud

Sweep nabs doctors, nurses, and medical professionals

The U.S. Department of Justice has arrested 243 people across the country and has charged them with submitting fake billing for Medicare totaling $712 million, according to a Reuters report.

Attorney General Loretta Lynch described the arrests as the largest criminal health care fraud takedown in the history of the Justice Department. Those arrested included 46 doctors, nurses, and other licensed medical professionals.

The charges are based on a variety of alleged fraud schemes, the government said, including submitting claims to Medicare and Medicaid for treatments that were medically unnecessary and often never provided.

Many of the arrests were in Florida, long an epicenter of Medicare fraud. In Miami, 73 defendants were charged with offenses involving approximately $263 million in false billings. One mental health facility there billed close to $64 million for psychotherapy sessions that were nothing more than moving patients to different locations, Lynch said in a press conference.

Other cities involved include Houston, Dallas, and McAllen, Texas; Los Angeles, California; Detroit, Michigan; Tampa, Florida; Brooklyn, New York; and New Orleans, Louisiana.

One case in Michigan involved a doctor who prescribed unnecessary narcotics in exchange for patients’ identification information, which was used to generate false billings. The patients then became addicted to the prescription narcotics and were bound to the scheme as long as they wanted to keep their access to the drugs.

“In the days ahead, the Department of Justice will continue our focus on preventing wrongdoing and prosecuting those whose criminal activity drives up medical costs and jeopardizes a system that our citizens trust with their lives,” Lynch said.

Since 2007, as part of increased efforts to tackle Medicare fraud, federal authorities have charged nearly 2,100 people with falsely billing the Medicare program more than $6.5 billion, according to the Justice Department. The recent arrests bring that total to more than 2,300 people who have billed more than $7 billion.

Source: Reuters; June 18, 2015.

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