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Medicare, Medicaid Cheats Arrested in Sweeping Healthcare Fraud Sting

1 year ago
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Calling it the largest health care fraud sting in U.S. history, the Justice Department announced charges Friday against 94 people accused of cheating Medicare and Medicaid, The Washington Post reported.

Federal agents arrested suspects in five states, rounding up patients, doctors and executives at health care firms. They are accused of bilking the Medicare system out of more than $251 million through false claims for services that were medically unnecessary or never provided, according to the Post.

Thirty-six people had been arrested as of Friday afternoon and 58 were still being sought.

Some of the alleged schemes were blatant, the Post said:

In one alleged $70 million scheme operated out of a New York City clinic, more than 1,000 cash kickbacks were paid to Medicare beneficiaries out of a designated "kickback room," Lanny A. Breuer, assistant attorney general for Justice's criminal division, said at a news conference. An undercover investigation showed that beneficiaries lined up to receive illegal payments near a sign showing a woman with her finger to her lips warning in Russian, "Don't Gossip," Breuer said.

The charges include conspiracy to defraud the Medicare and Medicaid programs, criminal false claims, violations of anti-kickback statutes and money laundering. Many of the alleged schemes involve phony claims to Medicare and Medicaid for physical and occupational therapy, home health care, and other treatments.

Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius (pictured) announced the arrests during the first in a series of regional meetings on health care fraud prevention in Miami.

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ens37167

A Medicaid doctor destroyed my nose and face with extreme, obsolete and unnecessary surgeries. He told me he was going to remove some nasal polyps. I had gone to see him for ear ringing. Treatment for the iatrogenic conditions caused by this doctor have cost the taxpayers hundreds of thousands of dollars, not to mention that my life is ruined. The cost of health care has not skyrocketed due to lawsuits. The inflated cost is due to corruption in the medical industry. I am encouraged to see law enforcement going after these criminals.

http://www.emptynosesyndromesite.com/

July 17 2010 at 8:28 PM Report abuse -1 rate up rate down Reply
Pursvll

The big fraud of this country is the Social Services department. I know several people that are not married and have a baby and their boy friend won't work and is living with the girlfriend and welfare is keeping them up. They get a place to live,lights, water, and phone and 250.00 food stamps free for her, baby and lazy boyfriend. The goverment doesn't give these people any incentive to work because these people know that the goverment is going to keep them up. Obama should start cleaning this department up and leave the Social Security alone. At lease the people on ss worked.

July 17 2010 at 2:17 PM Report abuse +3 rate up rate down Reply
eelspear

Glad they're caught. Hope it will serve as a warning, and not depreciate the good work done in the USA on health care reform.

July 17 2010 at 12:53 PM Report abuse +2 rate up rate down Reply
jsue4444

I am appalled and ashamed of those who would cheat and fraud the old, the poor, the infirm; in other words their brothers and sisters on this earth. How can people live with themselves? I keep thinking that people can't surprise me anymore,but they do.

July 17 2010 at 11:59 AM Report abuse +6 rate up rate down Reply
1 reply to jsue4444's comment
dc walker

Americans have a target on their back; ask any foreign drug dealer. They don't ply their trade in poor countries but they know they can hook Americans because they have money. That is true elsewhere, lack of oversight, no one is responsible when they receive or give out government money. We need to cut the government agencies in Washington and return the monies to the states (Revenue sharing) where they can monitor the flow of money.

July 17 2010 at 12:42 PM Report abuse +1 rate up rate down Reply
ryanptatc

JAIL TIME!!! ALSO, THINK ABOUT THE PEOPLE WE GIVE HEALTH CARE TO THAT DON'T HAVE INSURANCE. IMAGINE HOW MUCH MONEY THAT WILL SAVE HOSPITALS AND DOCTORS, AND WE CAN THEN LOWER FEES! NO MORE HEALTH CARE TO PEOPLE WHO DON'T HAVE INSURANCE OR ARE HERE ILLEGALLY!

July 17 2010 at 11:24 AM Report abuse +2 rate up rate down Reply
lagabriel2

THERE SHOULD BE NO IF AND'S OR BUT'S THESE PEOPLE GO TO JAIL AS FAST AS WE CAN GET THEM THERE,YOU DID IT ,YOU LOSE. PEOPLE WILL BE WATCHING HOW THIS PLAYS OUT.

July 17 2010 at 11:03 AM Report abuse +6 rate up rate down Reply
avbysandy

MANDATORY JAIL TIME!! Or better yet WORK camps!

July 17 2010 at 10:43 AM Report abuse +6 rate up rate down Reply
mpdc2708

An excellent job of all those involved with a multifaceted investigation. I know from personal experience as in the recent (2 yrs) death of my mother, that medical personal slam grieving families with medical bills. Of course, they are to be paid by medicaid but still I carefully reviewed each one and was amazed at how far some will go to collect medicaid money. For example, one ER doctor sent an "additional hour" of emergency billing 1 1/2 years after the event. This followed another physician billing medicaid for an unusual office visit by my mother for follow-up treatment. So, I kindly called the physician's office and asked the receptionist to tell my mother that the next time she comes to their office for a medical appointment, please ask her to phone home. (My mother lived with me.) The unidentified woman seemed unsure of my request & asked if there was a problem? I told her that there was indeed and I said to her, "You see, my mother & I have always been very close, we're nearly inseparable, but apparently nearly two years after her death, she came in to see you for a medical examination to which I just received a copy of the bill. So, the next time you see mom please ask her to come home and see me too."

July 17 2010 at 6:51 AM Report abuse +11 rate up rate down Reply
djshaff2

Yes thats hospice for ya. These elderly people get ripped off big time. Can you imagine the money medicare, and medicaid can save for situations like this. I feel each state should investigate

July 17 2010 at 3:06 AM Report abuse +4 rate up rate down Reply
jkessler77

It's just so frustrating that so many people do this kind of Fraud stuff. (from car insurance fraud, intentional fires, bogus medical claims etc etc etc) Because it is "us", the American Tax Payers who end up paying for their greed. There definatly has to be more "policing" and "regulating" of these type scams. The Welfare system has soo many people who "expect" to be taken care of...just because the are not willing to work. These people will go out of their way to make sure they "cannot work", or are not "employable".
Many spend their life, looking for the "free ride", rather than actually work. That is why there is so many Law Suits...they wanna get something for nothing. I wish they would get off their lazy butts, and try to be a productive citizen, rather than a burden.
I believe it was JFK, (sorry, I am politically ignorant) who once said, "Ask Not What Your Country Can Do For You, But What You Can Do For Your Country." Yeah right! I see so much of the opposite, that it sickens me.
I have a friend, who just 6 days ago, suffered a Heart Attack. He was at the local Albertsons store. He collapsed at the check-out stand, and when he stopped breathing...no one did anything, or tried to give CPR! He is in a coma now, after going over 10 minutes without oxygen, before the paramedics got there.
Would I have jumped in and gave CPR, if I had witnessed this? I sure hope so, but like so many people nowdays, we are conditioned to think that we could get "sued". Sad, and pathetic really, that this friend of mine who is only 47 years old, would probably be fine & home by now...if someone would have just pounded him a few times on the chest. But, instead, he was moved to the Hospice section of the hospital this morning.

July 17 2010 at 2:28 AM Report abuse +6 rate up rate down Reply

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