In Miami, the owners of a mental-health treatment center allegedly billed Medicare for tens of millions of dollars’ worth of intensive therapy that actually involved just moving people to different locations. Some of them had dementia so severe that they couldn’t even communicate.
In Los Angeles, prosecutors say, one doctor collected $23 million for more than 1,000 power wheelchairs and other equipment his patients didn’t need — which he often didn’t even provide.
And in Michigan, another physician allegedly prescribed unnecessary narcotic painkillers in return for the use of his patients’ IDs to generate additional false billings. When they tried to escape the scheme, authorities say, he threatened to cut off the medications, to which his patients were addicted.
It turns out that the government was checking on these and other doctors, nurses and providers of psychotherapy, home care, drugs, physical therapy and medical equipment. In the single largest crackdown in an eight-year campaign against health-care fraud, the Justice Department charged 243 people Thursday with $712 million in false billings to Medicare — the medical insurance program for the elderly — and Medicaid, which serves the poor.
Some of the schemes were so brazen that FBI Director James B. Comey likened health-care providers to “ATMs” for the unscrupulous.
“If you want to find criminals, you follow the money,” Comey said at a news conference to announce the charges. “In this case, we followed the money and found criminals who were attracted to doctor’s offices, to clinics, to hospitals, to nursing homes in search of what they viewed as an ATM, an ATM that was a freebie to them but is actually filled with taxpayers’ money.”
The alleged fraud spanned the country, from Miami — where
73 of the accused worked — to Houston, Dallas, Los Angeles, New York, New Orleans, Detroit and beyond. A sizable number allegedly targeted Medicare Part D, the prescription-drug benefit that is the fastest-growing part of the huge program.
Since it was put together in 2007, the government “strike force” that focuses on health-care fraud has charged more than 2,300 people accused of falsely billing Medicare for more than $7 billion. Its efforts have been expanded with $350 million provided under the Affordable Care Act.
Medicare has long been an enticing target for fraud. Last year, The Washington Post reported, a power wheelchair scam netted perpetrators untold amounts of the program’s money over 15 years. In 2011, a Miami health-care executive was sentenced to 50 years in prison for submitting more than $205 million in phony claims.
As in the past, many of the current cases involve people who allegedly recruited patients, the beneficiaries themselves and others who allegedly received kickbacks for their involvement, the government charged.