91 charged with $430 million Medicare billing fraud

Published on October 6, 2012 at 4:17 AM · No Comments
The nationwide sweep involved arrests of doctors, nurses and other licensed medical professionals.

Los Angeles Times: Feds Charge 91 Healthcare Providers With Billing Fraud
A federal healthcare strike force has charged 91 doctors, nurses and other licensed medical professionals in a nationwide sweep in connection with fraudulently billing the government nearly $430 million. Those charged included a group in Los Angeles that ferried patients for ambulance rides that were never medically necessary (Serrrano, 10/4).

Reuters: Authorities Charge 91 In $430 Million Medicare Fraud
Ninety-one people including doctors, nurses and other medical professionals were charged criminally in a new sweep of Medicare fraud involving seven U.S. cities and $430 million in alleged false billing, officials said on Thursday. It was the government's second big raid in recent months after a similar effort in May alleged $452 million in fraud in Medicare, the U.S. health program for the elderly and disabled (Ingram and Morgan, 10/4).

Bloomberg: U.S. Charges 91 Over Millions In False Medicare Bills
U.S. authorities charged 91 people with Medicare fraud in a nationwide crackdown, alleging schemes involving $429.2 million in false billing, Attorney General Eric Holder said. Doctors, nurses and other medical professionals were among those who billed Medicare for unnecessary services and paid kickbacks to acquire patient information for fraudulent bills, Holder said today at a news conference in Washington (Mattingly, 10/4).

CQ HealthBeat: Medicare Fraud Operation Results In Charges Against 91 In Seven Cities
Attorney General Eric H. Holder Jr. and Health and Human Services Secretary Kathleen Sebelius announced the nationwide operation at a Thursday afternoon news conference with law enforcement and HHS officials who participated in the strike force effort. ... Together, those indictments charge more than $230 million in home health care fraud; more than $100 million in mental health care fraud; more than $49 million in ambulance transportation fraud; and millions more in other frauds (10/4).

Politico Pro: DOJ Announces $430M In Medicare Fraud
The Medicare Fraud Strike Force has arrested 91 people in seven cities for Medicare fraud schemes totaling approximately $430 million, Attorney General Eric Holder announced Thursday. "Over the last 24 hours, Medicare Fraud Strike Force operations in seven different cities have conducted one of the largest health care fraud takedowns on record," Holder said. ... He said defendants were charged in Miami, Los Angeles, Dallas, Houston, New York City, Chicago and Baton Rouge, La., for schemes including home health care, mental health care and ambulance fraud (Smith, 10/4).

Houston Chronicle: FBI Arrests Historic Houston Hospital's CEO, Son, 5 Others
After 30 years as CEO of one of Houston's most historic hospitals, Earnest Gibson III, along with his son and five others, was arrested on Thursday -- part a national Medicare fraud sweep involving $430 million in bogus billings and 91 health care providers in seven states. If the allegations against the 68-year-old Gibson are true, that he and others at the hospital bilked the Medicare program of $158 million over a period of more than seven years, it could prove lethal for Riverside, once the primary hospital for the city's black population. Gibson and his son Earnest Gibson IV, 35, were charged with 13 counts: conspiracy to commit health care fraud; conspiracy to defraud the United States and pay and receive health care kickbacks; one count of money laundering and ten counts of violating the anti-kickback statute (Langford, 10/4).

CNN Money: Medicare Fraud Case: 91 Professionals Arrested
The Justice Department announced criminal charges Thursday against 91 people who allegedly received about $430 million through wide-ranging Medicare fraud. ... Among those arrested by the FBI Thursday was Ernest Gibson, the president of Riverside General Hospital in Houston, along with his son, who is also an employee of the hospital, and four others associated with the hospital. "We are going after people, whatever their positions, whatever their level," said Holder (Isidore, 10/4).

Medpage Today: Medicare: Feds Charge 91 In Fraud Sweep
In Dallas, 14 individuals -- including two doctors and two registered nurses -- were charged for their alleged involvement in $103.3 million in false billings. In one case involving a home healthcare company, Joseph Megwa, MD, signed roughly 33,000 prescriptions for more than 2,000 beneficiaries from 2006 to 2011; many beneficiaries had primary care physicians who never certified home healthcare services for them. ... In Brooklyn, 15 people, including one doctor, were charged in various fraud schemes costing Medicare $23.2 million, including paying cash for physical therapy that was never provided in some cases (Pittman, 10/4).

Meanwhile, in other news -

Reuters: FDA Cracks Down On Websites Selling Bad Drugs
The U.S. Food and Drug Administration said it has cracked down on thousands of online pharmacies for selling potentially unsafe, unapproved or fake medicines, including the erectile dysfunction drug Viagra and antiviral Tamiflu. The FDA, working with international regulatory and law enforcement agencies from about 100 countries, said on Thursday that it took action against more than 4,100 Internet pharmacies, bringing civil and criminal charges, removing offending websites and seizing drugs worldwide (Sherman and Berkrot, 10/4).


http://www.kaiserhealthnews.orgThis article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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