Attorney General Eric Holder and Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services, said Medicare Fraud Strike Force operations, part of the Health Care Fraud Prevention & Enforcement Action Team, was created in 2009 by the Department of Justice and HHS to coordinate efforts to prevent fraud and enforce current federal anti-fraud laws.
It is a multi-agency team of some 400 law enforcement agents from the FBI, HHS-Office of Inspector General, Medicaid fraud control units and other federal, state and local law enforcement agencies designed to combat Medicare fraud via Medicare data analysis and community policing.
The defendants allegedly participated in schemes to submit Medicare claims for treatments that were medically unnecessary and often never provided, court documents said. For example, a Los Angeles doctor was charged for causing almost $24 million in losses to Medicare through his own fraudulent billing and referrals for durable medical equipment, including more than 1,000 power wheelchairs, and home health services unnecessary and often not provided.
Collectively, the doctors, nurses, licensed medical professionals, healthcare company owners and others charged are accused of conspiring to submit approximately $260 million in fraudulent billings.
"The Affordable Care Act has given us additional tools to preserve Medicare and protect the tens of millions of Americans who rely on it each day," Sebelius said.
"By expanding our authority to suspend Medicare payments and reimbursements when fraud is suspected, the law allows us to better preserve the system and save taxpayer dollars. Today we're sending a strong, clear message to anyone seeking to defraud Medicare: You will get caught and you will pay the price. We will protect a sacred trust and an earned guarantee."
Since its inception, strike force operations in nine locations charged almost 1,900 defendants who collectively falsely billed Medicare for almost $6 billion. In addition, it removed more than 17,000 healthcare providers from the Medicare program since 2011.