On September 7, 2011, Attorney General Eric Holder and Secretary of Health and Human Services Kathleen Sebelius jointly announced what they called a “nationwide takedown” by the Medicare Fraud Strike Force that led to charges of Medicare fraud against 91 individuals, including physicians, nurses, and other medical professionals, in eight U.S. cities. The unsealed court documents indicate that the defendants allegedly participated in schemes to bill Medicare for services that were medically unnecessary and, in many cases, not rendered.
Many of the charges involved patient recruiters, where Medicare beneficiaries are paid kickbacks for their part in schemes to bill Medicare for services the beneficiaries never received or did not need. According to the DOJ press release, this coordinated effort, which also included OIG and FBI, uncovered a variety of fraud schemes involving home health, physical and occupational therapy, mental health services, psychotherapy, and durable medical equipment.
The Government takes health care fraud very seriously. The Government is devoting a huge amount of resources to fight fraud, and a number of federal and state agencies are working tirelessly to root out fraud and protect the Medicare trust fund. Providers should regularly audit and monitor their Medicare and Medicaid billings to ensure they do not end up the target of a Government enforcement action.