September 7, 2011 / 7:26 PM / 8 years ago

Scores charged in massive healthcare fraud scams

MIAMI (Reuters) - Ninety-one suspects, including doctors and nurses, have been charged in connection with a new rash of healthcare fraud schemes aimed at bilking the government out of about $295 million, U.S. authorities said on Wednesday.

Attorney General Eric Holder, Health and Human Services Secretary Kathleen Sebelius and FBI Executive Assistant Director Shawn Henry announced the charges in Washington, saying they resulted from strikes targeting crime rings in eight U.S. cities that preyed on Medicare, the federal health insurance plan for the elderly and disabled.

“From Brooklyn to Miami to Los Angeles, the defendants allegedly treated the Medicare program like a personal piggy bank,” the head of the Justice Department’s criminal division, Lanny Breuer, told reporters in Washington.

The anti-fraud sweep over the last two weeks involved some 400 law enforcement agents from the FBI, HHS-Office of the Inspector General, multiple Medicaid Fraud Control Units, and other state and local law enforcement agencies.

Officials said the operations took place in Miami, Houston, Baton Rouge, Los Angeles, Detroit, Dallas, New York and Chicago.

Around half of the defendants were charged in Miami, the southeastern city widely viewed by law enforcement experts as the healthcare fraud capital of the United States.

The Miami defendants alone were accused of participation in fraud schemes involving a total of nearly $160 million in false billings for home and mental health services, occupational and physical therapy, HIV infusion, and other services.

“South Florida remains ground zero for healthcare fraud,” John V. Gillies, special agent in charge of the FBI’s Miami division, told reporters in Miami.

According to court documents, the defendants allegedly participated in schemes to submit claims to Medicare for treatments that were medically unnecessary and often never provided.

Gillies said 42 suspects had been arrested on Tuesday and Wednesday in the Miami area, where authorities were still looking for three fugitives.

Despite what he and others touted as the success of the latest crackdown on healthcare fraud, Gillies said he saw no end to the Medicare fraud problem any time soon.

“We have dozens and dozens of cases to go,” said Gillies, referring to a fraud that the FBI has estimated to cost U.S. taxpayers anywhere between $70 billion and $234 billion a year.

“I don’t have all the resources I need. I don’t believe the IG’s Office (Office of Inspector General) has all the resources that they need,” Gillies said, when asked about the money and manpower needed to fight one of America’s top crime problems.

He said south Florida was also No. 1 in mortgage fraud and No. 2 in securities fraud, and has significant gang problems.

Reporting by Tom Brown in Miami and Jeremy Pelofsky in Washington; Editing by Pascal Fletcher and Eric Walsh

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