53 Indicted in Medicare Fraud Sting
Administration Focuses on Problem Amid Health-Care Debate

By Carrie Johnson
Washington Post Staff Writer
Thursday, June 25, 2009

The Justice Department yesterday unsealed criminal indictments against 53 people for allegedly bilking the Medicare system, the latest step in a wide-ranging effort to prevent fraud that costs the federally funded health program billions of dollars each year.

Federal agents arrested dozens of people in Miami and Detroit for allegedly submitting Medicare claims for $50 million in treatments that were unneeded and sometimes never provided, authorities said.

The indictments returned by a grand jury in Detroit focus mostly on costly HIV-AIDS infusion drugs and physical and occupational therapy. Authorities filed criminal charges against patients, doctors, medical assistants and company owners who allegedly played complicit roles in the fraud schemes. Prosecutors are seeking forfeiture of the criminal proceeds and restitution to the Medicare program.

The cost of Medicare, which covers the elderly and disabled, and Medicaid, its sister program for the poor, are growing as the American population ages, giving new urgency to initiatives to detect and prevent phony claims.

The action was announced at a news conference in the District by Attorney General Eric H. Holder Jr., Health and Human Services Secretary Kathleen Sebelius, and FBI Director Robert S. Mueller III, a signal that the Obama administration is giving the issue high priority as it pushes for legislative reforms in health care.

"We will strike back against those whose fraudulent schemes not only undermine a program upon which 45 million aged and disabled Americans depend, but which also contribute directly to rising health-care costs," Holder said.

The arrests come a month after officials at the Justice Department and HHS committed to sending investigators and prosecutors to Detroit and Houston, following earlier health fraud crackdowns in Miami and Los Angeles. Government analysts working for the Health Care Fraud Prevention and Enforcement Action Team are poring over electronic billing data and crime patterns to better target their efforts.

Sebelius said the action was an effort to employ "all the weapons in the federal government's arsenal to target those who are defrauding the American taxpayer."

Mueller said that agents have 2,400 open health-care fraud investigations and that the bureau is using a range of investigative methods to attack the problem, including wiretaps and undercover agents.

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