Busted: 91 Doctors, Nurses, Medical Professionals Charged In $430M Medicare Fraud
The U.S. Justice Department and the Department of Health and Human Services discovered alleged false billing schemes involving $230 million in home health services, over $100 million in mental services, and $49 million from ambulance transportation. Ninety-one people, including: doctors, nurses, and other medical professionals, have been charged with committing over $430 million in Medicare fraud in seven U.S. cities. The scheme is the largest of its kind, according to Attorney General Eric Holder. The announcement marks the latest case in a concerted crackdown against Medicare fraud by an inter-agency Medicare fraud strike force.
The charges the suspects face range from healthcare fraud and conspiracy to wire fraud, kickback violations, identity theft and money laundering. In a news conference, Holder said that the case reveals an alarming trend of criminal attempts to steal billions of taxpayer dollars for personal profit. ”Today’s enforcement actions reveal an alarming and unacceptable trend of individuals attempting to exploit federal health care programs to steal billions in taxpayer dollars for personal gain,” Holder said. Assistant Attorney Lanny A. Breuer agreed, adding: “Today’s coordinated actions represent one of the largest Medicare fraud takedowns in Department of Justice history.” Breuer continued : “We have made it one of the Department’s missions to hold accountable those who abuse the Medicare program for personal profit.”
Medicare Fraud Strike Force operations targeted health care workers in seven cities – Brooklyn, Baton Rouge, Chicago, Dallas, Houston, Los Angeles, and Miami. According to Holder, Dr. Joseph Megwa, was writing 33,000 prescriptions for some 2,000 patients between 2006 and 2011. Dr. Megwa, who practices in Dallas, allegedly signed off these documents without reviewing them, causing $103.3million in false billings. According to the Dallas Morning News, the 58-year-old’s alleged defrauding was the costliest. The doctor, who works at Raphem Medical Practice in Arlington, was indicted on conspiracy and health-fraud. The Justice Department alleges that Megwa helped patients in their homes as he travelled abroad. Two nurses, Ferguson Ikhile, and Ebolose Eghobor, were indicted along with the doctor. The three remain in federal custody.
Similarly, dermatologist Dr. Robert Kolbusz of Chicago, was charged with falsely diagnosing his patients and billing Medicare for treatments that were not given, according to the Chicago Tribune reported. Seven individuals in Houston were charged for giving kickbacks of cigarettes, coupons, and food to Medicare recipients who would in turn just watch TV or play games instead of receiving the services that were billed to Medicare. The fraud allegedly led to $158 million in fraudulent billing.
In Miami, 33 suspects were arrested and charged with fraud of more than $200 million, according to NBC Miami. Breuer said that owners and operators at one Miami psychiatric hospital gave cash kickbacks to owners of assisted living facilities in order to obtain more patients. They then billed the social insurance plan more than $67million, often for services that were never offered, or patients they never actually had. Breuer added that these 33 medical professionals then billed Medicare for the cash they used as kickbacks for their false patients. Little else is known about those charged in the city.
Holder condemned the fraud as one that “siphons precious taxpayer resources, drives up heath care costs, and jeopardizes the strength of the Medicare program.” He added: “They also victimize the most vulnerable members of society, including elderly, disabled, and impoverished Americans.” The strike force was created under the healthcare reform law as a means of curbing waste, fraud and abuse within the $590 billion Medicare program that provides healthcare benefits to approximately 50 million elderly and disabled beneficiaries.
In February of 2011, 111 medical practitioners were charged in a $225million Medicare fraud, which was the largest of its kind at that time.
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