Medicare Fraud Strike Force Announces Massive Health Care Fraud “Takedown”

The US Attorney General announced yesterday a “takedown” of 243 defendants over the last three days, representing the largest health care fraud enforcement effort in the Medicare Fraud Strike Force’s eight-year history and the largest criminal health care fraud action in the history of the Justice Department.

According to the Justice Department, the defendants’ alleged criminal conduct implicates approximately $712 million falsely billed to Medicare. The Attorney General explained that the defendants are alleged to have “billed for equipment that wasn’t provided, for care that wasn’t needed, and for services that weren’t rendered.” The defendants include doctors, patient recruiters, home health care providers, and pharmacy owners. Approximately one-fifth of the defendants are alleged to have defrauded the Medicare Part D prescription drug program.

Yesterday’s announcement involved enforcement actions over a three-day period spanning 17 federal districts across the country. Seventy-three of the defendants were charged in Miami with submitting $263 million in false billings. Other locations in which indictments were filed include Houston, McAllen, and Dallas, Texas; Los Angeles, CA; Detroit, MI; Tampa, FL; Brooklyn, NY; and New Orleans, LA.

The Medicare Fraud Strike Force is a joint initiative of the Justice Department and the Department of Health and Human Services, and comprises federal, state, and local law enforcement officials. During its eight-year history, the Strike Force is credited with filing charges against more than 2,300 individuals with fraud involving more than $7 billion in Medicare losses. Meanwhile, the Justice Department has recovered $15.3 billion over the last six years through False Claims Act cases involving fraudulent billing of federal health care programs. The Justice Department claims that it recovers an average of nearly $8 for every $1 it spends on enforcement.

The Justice Department’s press release is available here, and the Attorney General’s remarks are available here.