DOJ, in largest sweep yet, arrests 243 for alleged $712M in Medicare fraud

By Cate Chapman on June 22, 2015

The Dept. of Justice said its Medicare Fraud Strike Force charged 243 people in a nationwide sweep for alleged participation in Medicare fraud schemes involving about $712 million in false billings.

“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,” said Attorney General Loretta E. Lynch, referring both to the number of defendants charged and loss amount.

The defendants were charged with crimes including conspiracy to commit health care fraud, violations of the anti-kickback statutes, money laundering and aggravated identity theft, the DOJ said in a statement Thursday. More than 44 were charged with fraud related to the Medicare prescription drug benefit program known as Part D, the fastest-growing component of the program.

Patient recruiters, Medicare beneficiaries and other co-conspirators allegedly were often paid cash kickbacks in return for supplying beneficiary information to providers, so they could submit fraudulent bills to Medicare for services that were medically unnecessary and often never provided.

The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between DOJ and Health and Human Services.

Since its inception in March 2007, Strike Force operations in nine locations have charged over 2,300 defendants who collectively have falsely billed the Medicare program for over $7 billion. The sweep last week marks the first time that districts outside of  Strike Force locations participated in a national takedown, and they accounted for 82 defendants charged in this takedown, the DOJ said.