Federal agents raided health care facilities in nine states this morning, arresting dozens of suspects believed to be defrauding Medicare of tens of millions of dollars, ABC News has learned.
Federal authorities say this is one of the largest -if not the largest- take down of Medicare fraud suspects ever conducted.
The raids began this morning in the pre-dawn hours. The targets: more than 100 doctors, nurses, therapists and healthcare company executives who have allegedly been stealing tax dollars to the tune of $200 million in recent months. Sources say much of the fraud involved healthcare professionals billing the government for medical services never performed and medicine not provided.
Federal sources say the raids are being conducted in Miami, Brooklyn, Tampa, Chicago, Baton Rouge, Houston, Dallas, and Los Angeles.
ABC News was on the scene when federal agents closed in on a string of physical therapy clinics in Brooklyn, N.Y., this morning. Sources say the three clinics are suspected of bilking Medicare and Medicaid for more than $50 million over the last two years.
Investigators say the Brooklyn scheme worked like this: Patients willing to go along with the scam were paid $40 per visit for three appointments per week, and were often diagnosed with vertigo or other ailments that would limit their mobility. Ambulettes provided by Medicare and Medicaid were transporting these patients back and forth for fraudulent appointments.
The clinic would then collect from Medicare or Medicaid for the ambulette rides, and the supposed services provided at the phony appointments. Taxpayers were billed millions for unnecessary treatment or treatment never provided.
Seven of the nine Brooklyn suspects are in custody. ABC producers on the scene saw the some of the suspects being read their Miranda rights in Russian. In Miami this morning, federal agents arrested more than 30 Medicare fraud suspects. The indictment charges the defendants submitted tens of thousands of dollars in bogus claims for elderly and disabled patients.
The Department of Human Services estimates that Medicare fraud cost taxpayers more than $24 billion, just in 2009. HHS Inspector General Daniel Levinson told Congress recently that 1,300 investigations in the past year alone have resulted in 500 Medicare fraud convictions, and an estimated $3 billion in recovered funds. Because of the massive scale of the fraud, special Medicare strike forces were created beginning in 2007 to try to stem the flood of taxpayer dollars flowing to illegal operations.
Levinson told Congress, “Health care fraud schemes commonly include billing for services that were not provided or were not medically necessary, purposely billing for a higher level of service than what was provided, misreporting costs or other data to increase payments, paying kickbacks, and/or stealing providers’ or beneficiaries’ identities.”
And, he says, the perpetrators of these schemes range from street criminals, who believe it is safer and more profitable to steal from Medicare than trafficking in illegal drugs, to Fortune 500 companies that pay kickbacks to physicians in return for referrals.
Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius are planning a 12:30 p.m. news conference today in Washington to detail the arrests and announce an expansion of strike forces to crack down on Medicare fraud.
Source ABC News
