September 7th, 2011
03:19 PM ET

Justice Department charges 91 in $295 million Medicare fraud scheme

The Justice Department on Wednesday announced charges against 91 people including doctors, nurses and other medical professionals allegedly involved in a nationwide Medicare fraud scheme in eight cities totaling $295 million in false billing.

“The defendants charged in this takedown are accused of stealing precious taxpayer resources and defrauding Medicare – jeopardizing the integrity of our health care system and our nation’s most critical health care program for personal gain,” Attorney General Eric Holder said in a press release. “Our highly coordinated, nationwide Strike Force operations are working aggressively to combat Medicare fraud and our anti-health care fraud efforts have never been more innovative, collaborative, aggressive – or effective. We will continue to work with our law enforcement partners and partners across government to fight against health care fraud.”

According to the Justice Department those charged are accused of a variety of fraud-related crimes including conspiracy to defraud the Medicare program, health care fraud, violations of the anti-kickback statutes and money laundering. The scheme involved home health care, physical and occupational therapy, mental health services, psychotherapy and durable medical equipment services, the Justice Department said.

“Today’s arrests are a powerful warning to those who would try to defraud taxpayers and Medicare beneficiaries,” Health and Human Service Secretary Kathleen Sebelius said in a press release. "These arrests illustrate close cooperation between the Medicare program that identified these fraudsters and the law enforcement officials who acted swiftly to cut them off. And our efforts to stop criminals don’t end here because the Affordable Care Act gives us new tools to prevent Medicare fraud before it is committed – better protecting seniors and the integrity of the Medicare program for generations to come.”

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soundoff (132 Responses)
  1. woody

    Hey folks. this is 295 million of the 500 million in the new health care plan that republicans have so many problems with.What's their problem with catching crooks?

    September 7, 2011 at 6:10 pm | Report abuse | Reply
  2. gung hoe

    Hey ruffie Joey on a different thread that he thought that obama might be the better of two options I shuddered but had to agree with him Cant actually believe i am saying that

    September 7, 2011 at 7:43 pm | Report abuse | Reply
  3. Miss Kitty Russell

    Ooooh, Deputy Eric Holden I gonna go to corner goods store and order me up the prettiest silk dress from the catalogue a saloon girl buy...im thinking there's a new sheriff and it ain't Gunsmoke...you and your boys keep roundin' up those outlaws..

    September 7, 2011 at 7:59 pm | Report abuse | Reply
  4. justathought

    I suppose many of you have had a simular ER case like I did about a year ago. I fell and went to the ER where I had 3 stiches put in--the bill-- $1800, Medicade paid all but $50.00. But, pray tell how can the ER justify $1800 for 3 stiches? Were things reported as done, but never were? My sister (ret) who had whad worked in medical billing said the charges may have related tho the leanth of time I was just on the ER gurnny which was about an hour ($10/min) before the doctor did the job. The MD's fee was about $400.00, isn't that padding the bill a little for a steep for a 10min job? medicare paid 100% Maybe this is part of the reason Medicare is costing too much?

    September 7, 2011 at 8:14 pm | Report abuse | Reply
    • yono fui

      you r so right .. hospitals are the biggest sharks in the medicare fraud line. FEDS are the cops of very wealthy and powerful people . they are the only ones that can fraud at any level without getting busted !

      May 3, 2012 at 3:11 pm | Report abuse |
  5. ChumDaddy

    On 1/7/11 I went to Bayonne Medical Center in NJ for a three day Supply of my ANTI-depressant medication(I was due to see the Dr. on the 10th as I had just moved back here). I sat in a room in a gown for 3 hr's....I talked to 2 people for a total of about 10 mins. and was told they couldn't help me.....I was given discharge papers stating I should follow up with my Dr........? "NO REALLY?" 2 weeks later I recieved a BILL FOR $3650.00 that medicare paid $3500.00 towards.... How BOUT THEM Prices??????? I was sickened and just couldn't understand how they could justify taking advantage of a program that is way to Trusting..... Doesn't anyone look at the Bill ? Or does a robot just generate the checks???????

    September 7, 2011 at 9:34 pm | Report abuse | Reply
    • PF

      Actually, every patient should look at their bill and question the amounts when appropriate – which seems to be often. We will only control medical costs when each patient gets aggressive about the bills- and we begin to push back and sky-high billing procedures. And, we'll have to get ready for triage – it has always been there for the poor -you can't all have super expensive procedures from chronic illnesses and when we get close to death – no system can afford it for long. There are limits, period.

      September 7, 2011 at 10:58 pm | Report abuse |
  6. evensteven

    I heard of one situation in Alamogordo New Mexico where there is a hospital with 100 beds and 800 employees. That's 8 employees for every bed, and usually there are no more than 30-35 patients in the hospital at anyone time so actually there are about 20-24 employees per bed.

    Does that sound potentially fishy or at least wasteful to anyone else?

    September 8, 2011 at 12:24 am | Report abuse | Reply
    • Celia

      There are shifts involved with hospitals, some of the staff works nights and evenings. Hospitals are open 24 hours a day. They need nurses, ancillary staff, kitchen help, technicians, house keepers, etc. I worked at the hospital in Alamagordo and did the staffing. I can assure you they don't have any staff they don't need. Why would they?

      September 8, 2011 at 4:23 am | Report abuse |
  7. Beefburger

    Wait until Obamacare kicks in. This is going to be nothing in comparison to then.

    Should have told the public that "Universal Healthcare" would be an added benefit to Medicare, that way you could have fixed both from the inside out. Now Medicare recipients have formed a "human shield" around their addiction and it will remain a cripple deaf mute.

    September 8, 2011 at 2:06 am | Report abuse | Reply
  8. Beefburger

    "The System" needs to police itself. You want to make grandma and grandpa responsible for these crooks getting away with crap like this?

    Seriously, if you are expecting 80 year olds to be able to do financial forensics in a billing system frought with deliberate obfuscation then we are all S-C-R-E-W-E-D!

    September 8, 2011 at 2:21 am | Report abuse | Reply
  9. ararat

    they are not armenian, and this is another record on medical fraud, and they don't mention the nationality like they do with armenians.

    September 8, 2011 at 11:24 pm | Report abuse | Reply
  10. ararat

    since a nationality is not being mentioned, im going to take a WILD GUESS: JEWS!

    September 8, 2011 at 11:28 pm | Report abuse | Reply
  11. pzdqtutd

    pat tillman jersey

    December 29, 2011 at 9:16 pm | Report abuse | Reply
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