False Claims Totaling $223 Million Charged by Medicare Fraud Strike Force

June 7, 2013 — In the fight against Medicare fraud, lawyers with the Justice Department return millions of taxpayer dollars to the government every year through the use of the federal False Claims Act. Under the qui tam language of the Act, health care employees and professionals who discover fraudulent Medicare schemes are authorized to file a lawsuit against unscrupulous health care providers for the government’s benefit. Whistleblowers keep a share of the amount collected by the government. Although anyone with unique information about false claims is permitted to bring a suit, insider informants are frequently the ones to spot fraud first and put an end to it with a False Claims Act lawsuit.

Medicare Fraud Strike Force in Eight Cities Charges 89 Individuals

A Medicare Fraud Strike Force has charged health care professionals in eight cities for participating in Medicare fraud schemes amounting to more than $223 million in false claims for reimbursement to Medicare. This was the sixth national coordinated Medicare fraud takedown, according to the Justice Department. Those charged are alleged to have participated in a variety of health care fraud-related offenses, including kickbacks and money laundering, in connection with home health care services, mental health services, physical and occupational therapy, psychotherapy, ambulance services and durable medical equipment (DME).

The takedown occurred in the following eight cities:

  • Baton Rouge, LA:  5 defendants participating in $81 million in false billings for home health care and a community mental health care center.
  • Brooklyn, NY:  4 defendants involving multi-million dollar fraud schemes for physical therapy by unlicensed individuals
  • Chicago, IL:  7 defendants involved in various health care fraud scams
  • Detroit, MI:  18 defendants charged with $49 million in fraudulent billings for medically unnecessary home health services, infusion therapy and psychotherapy
  • Houston, TX:  2 defendants in an $8.1 million home health care fraud scheme
  • Los Angeles, CA:  13 defendants in health care scams totaling $23 million concerning DME and other false claims
  • Miami, FL:  25 defendants involving a total of $44 million in false billings for home health care, occupational and physical therapy, mental health services, HIV infusion and DME
  • Tampa, FL:  9 defendants charged in millions of dollars of pharmacy fraud and billings for phony surgeries

Whistleblowers in False Claims Act Lawsuits Often Health Care Insiders

Instances of Medicare fraud like those charged in the government’s recent takedown often surface when conscientious insiders take action. We understand that it is not always easy to notify the government when your co-worker or employer is engaged in misconduct. Tipsters who collaborate with the Justice Department deserve to understand their own legal rights before they come forward. With law offices across the country, Waters & Kraus provides informants with the experienced legal representation they need. Contact us by email or call our qui tam attorneys at 855.784.0268 to learn how we can assist you.

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