The federal government’s aggressive health care fraud enforcement continued on May 14 when the Health Care Fraud Prevention and Enforcement Action Team (HEAT) announced a nationwide takedown of 89 individuals for alleged health care fraud schemes. These people, including 14 doctors and nurses, were charged for their roles in separate Medicare scams that billed the taxpayer-funded program for roughly $223 million in false charges.
The arrests on Tuesday were part of a massive bust spanning eight cities where federal agents raided businesses, seized documents and charged suspects. The charges are based on violation of the federal fraud and abuse and anti-kickback statutes, as well as violations under the False Claims Act. The fraudulent conduct stemmed from submitting false claims to Medicare for purchases, treatments and services that, according to federal officials, either were medically unnecessary or never provided. In many cases, patient recruiters, Medicare recipients and others were paid cash to supply beneficiary information that later was used in billing scams.
Most of the alleged fraud involved home health care services, but the charges included mental health services, psychotherapy, physical and occupational therapy, durable medical equipment and ambulance services.
HEAT is a joint initiative between the Department of Justice and the Department of Health and Human Services formed to prevent and deter health care fraud and enforce anti-fraud laws.