Wifredo A. Ferrer, United States Attorney for the Southern District of Florida; Michael B. Steinbach, Acting Special Agent in Charge, Federal Bureau of Investigation (FBI), Miami Field Office; Christopher B. Dennis, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG); and Tony Gomez, Acting Inspector in Charge, U.S. Postal Inspection Service, Miami Division, announced that 33 South Florida residents were charged for their alleged participation in various schemes to defraud Medicare out of more than $202 million. The charges in South Florida are part of a nationwide takedown by Medicare Fraud Strike Force operations in seven cities that resulted in charges against 91 individuals, including doctors, nurses, and other licensed professionals, for their alleged participation in Medicare fraud schemes involving approximately $429.2 million in false billing.
In this national operation, dozens of charged individuals were arrested or surrendered in the last 24 hours as indictments were unsealed across the country. Together, those indictments charge more than $230 million in home health care fraud; more than $100 million in community mental health care fraud; and more than $49 million in ambulance transportation fraud.
The joint Department of Justice and HHS Medicare Fraud Strike Force is a multi-agency team of federal, state, and local investigators and prosecutors designed to combat Medicare fraud through the use of Medicare data analysis techniques. More than 500 law enforcement agents from the FBI, HHS-OIG, U.S. Postal Inspection Service, and other state and local law enforcement agencies participated in the national takedown.
U.S. Attorney Wifredo A. Ferrer stated, “Holding accountable those who abuse Medicare for personal profit is one of my top priorities. Those individuals who steal from Medicare are not just stealing from the government. Instead, they are stealing from the most vulnerable among us—the sick, the elderly, and the poor. We will not relent in our efforts to prosecute these fraudsters, bring them to justice, and seize their illegal income and assets for ultimate return to the Medicare program.”
“Over one third of those charged today in this multi-city health care fraud takedown were from the Miami area, accounting for more than $202 million in fraud,” said Michael B. Steinbach, Acting Special Agent in Charge of FBI Miami Division. “The FBI and its partners devote vast resources to investigate, catch, and prosecute those committing health care fraud. To attack the problem from both ends, tougher regulation and oversight are key to reducing the amount of fraud from occurring in the first place.”
“Here in South Florida, we must remain vigilant to address healthcare fraud in its many evolving forms,” said Christopher B. Dennis, Special Agent in Charge of the U.S. Department of Health and Human Services’ Office of Inspector General Miami region. “When hospitals, home health agencies, pharmacies, or other health care providers are suspected of breaking the law, they should expect swift justice.”
Tony Gomez, Acting Inspector in Charge for the U.S. Postal Inspection Service stated, “The U.S. Postal Inspection Service will continue to partner with the U.S. Attorney’s Office and the law enforcement community to ensure that the U.S. mail is not a conduit for this kind of fraudulent activity.”
The South Florida defendants are accused of various health care fraud-related crimes, including conspiracy to commit health care fraud, health care fraud, violations of the anti-kickback statutes, and money laundering. The charges are based on a variety of alleged fraud schemes involving various medical treatments and services such as home health care, mental health services, and physical and occupational therapy. According to court documents, the defendants allegedly participated in schemes to submit claims to Medicare for treatments that were medically unnecessary and oftentimes never provided. In many cases, court documents allege that patient recruiters, Medicare beneficiaries, and other co-conspirators were paid cash kickbacks in return for supplying beneficiary information to providers, so that the providers could submit fraudulent billing to Medicare for services that were medically unnecessary or never provided.
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