Medicare Fraud Strike Force Arrests 91 – 33 in South Florida

sebelius-holder-announcementWASHINGTON, D.C. (October 4,2012) Today, U.S. Attorney General Eric Holder and U.S. Department of Health and Human Services Secretary Kathleen Sebelius announced at a joint press conference that Medicare Fraud Strike Force operations conducted one of the largest health care fraud takedowns in history.
Charges have been brought in seven cities from Brooklyn to Los Angeles against 91 individuals – including doctors, nurses, and other licensed medical professionals – for their alleged participation in fraud schemes involving nearly $430 million in false billings.
Charges include health care fraud, conspiracy to commit health care fraud, wire fraud, violations of the anti-kickback statutes, aggravated identity theft, and money laundering charges are based on a variety of alleged activities involving treatments and services that were medically unnecessary or never actually rendered.
The alleged fraudulent schemes range from home health care and mental health services, to psychotherapy, physical and occupational therapy, durable medical equipment services, and the largest ambulance fraud scheme ever prosecuted by the Medicare Fraud Strike Force.
The joint press release by the Department of Justice and Department of Health and Human Services announced that “in Miami, a total of 33 defendants are charged for their alleged participation in various fraud schemes involving a total of $204.5 million in false billings for home health care, mental health services, occupational and physical therapy, and DME.
In one case, three defendants are charged for participating in a fraud scheme at LTC Professional Consultants and Professional Home Care Solutions Inc. which led to approximately $74 million in fraudulent billing for home health care.”
In another South Florida case, according to the indictment, the owners and operators of Hollywood Pavilion, psychiatric hospital, have been charged with paying cash kickbacks to owners and operators of assisted living facilities and halfway houses to obtain patients, and then billing Medicare for over $67 million in mental health services that were unnecessary or never even provided. The indictment alleges a scheme that is not new to South Florida and will feature a number of government witnesses who have previously testified in some of those cases.
In another Miami case, the government is restraining 40 bank accounts, and 16 residences valued at approximately $4.6 million, that belong to the owners and operators of a home health agency charged with defrauding Medicare to the tune of approximately $74 million.

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