Largest Healthcare Fraud Takedown Results in Charges Against 301 Individuals

HHS and the Department of Justice announced a nationwide sweep led by the Medicare Fraud Strike Force resulting in charges against 301 individuals for their alleged participation in healthcare fraud schemes involving $900 million in false billings.

The defendants are charged with various healthcare fraud-related crimes, including conspiracy to commit healthcare fraud, violations of the anti-kickback statues, money laundering, and aggravated identity theft. Included among the defendants are 61 doctors, nurses, and other licensed medical professionals.

“As this takedown should make clear, health care fraud is not an abstract violation or benign offense—it is a serious crime,” Attorney General Loretta E. Lynch said in a statement. “The wrongdoers that we pursue in these operations seek to use public funds for private enrichment. They target real people—many of them in need of significant medical care. They promise effective cures and therapies, but they provide none.”

More than 60 of the defendants are charged with fraud related to Medicare Part D. Defendants allegedly participated in schemes to submit claims to Medicare and Medicaid for treatments that were medically unnecessary and often never provided.

“Millions of seniors depend on Medicare for essential health coverage, and our action shows that this administration remains committed to cracking down on individuals who try to defraud the program,” said HHS Secretary Sylvia Mathews Burwell. “We are continuing to put new tools and additional resources to work, including $350 million from the Affordable Care Act, for healthcare fraud prevention and enforcement efforts.”

The most arrests took place in Florida with more than 100 individuals charged with offenses. Since 2007, Medicare Fraud Strike Force operations have charged more than 2900 defendants who collectively have falsely billed the Medicare program for more than $8.9 billion.

“While it is impossible to accurately pinpoint the true cost of fraud in federal healthcare programs, fraud is a significant threat to the programs’ stability and endangers access to healthcare services for millions of Americans,” said Inspector General Daniel Levinson of the HHS Office of Inspector General.