National Health Care Fraud in 2016 Hits $900 Million in False Billings

Michigan Doctors, Pharmacists, Physical Therapists, and Home Health Care Providers Alone Defrauded Medicare and Medicaid in Excess of $100 Million

US Attorney General Loretta E. Lynch and the Department of Health and Human Services (HSS) announced last Wednesday another nationwide sweep led by the Medicare Fraud Strike Force in 36 federal districts resulting in criminal and civil charges against 301 individuals, including 61 doctors, nurses, and other licensed medical professionals for their participation in health care fraud schemes involving false billings.  Twenty-Three state Medicaid Fraud Control Units also participated.  The amount is up almost $200 million from last year’s sweep.

Thirteen were indicted on Medicare/Medicaid prescription fraud charges in metro Detroit alone.  According to US Attorney Barbara McQuade, in the Eastern District of Michigan a total of 19 defendants face charges for their roles in fraud, kickbacks, money laundering, and drug distribution schemes involving approximately $114 million in false claims for services that were medically unnecessary or were never rendered.  Among this group were pharmacists and medical doctors and an owner of a physical therapy clinic who lured patients through the payment of cash kickbacks and medically unnecessary prescriptions for Schedule II medications for the purpose of stealing millions from Medicare.

According to an FBI special agent, “Dishonest health care providers and pharmacists who exploit Medicare and Medicaid through fraudulent billing and other schemes will be held accountable for their crimes, “ and “The FBI remains committed to investigating this type of fraud and bringing those who abuse the system to justice.”  We the taxpayers of this country and state applaud these efforts.  Thank you.