Feds charge 89 people, including doctors, nurses, with Medicare fraud

By Jeff Black, Staff writer, NBC News

Attorney General Eric Holder speaks during a news conference at the Justice Department in Washington on Tuesday.

In a major crackdown on healthcare fraud across the country, 89 people, including 14 doctors and nurses, were charged for their roles in various Medicare scams that bilked taxpayers of some $223 million through bogus charges, federal officials said Tuesday.

Some people allegedly posed as doctors and wrote bogus prescriptions for drugs and psychotherapy therapy and then billed the government $12 million.

Others are accused of bribing Medicare patients for their ID numbers, then using those numbers to bill $20 million in home health care never performed or not medically necessary.

The lead suspect in that case used the money to buy luxury cars, including two Lamborghinis and a Ferrari, officials said.

About 400 federal agents were involved in Tuesday's arrests, raiding businesses, seizing documents and charging suspects in Miami, Los Angeles, Houston, New York City, Detroit, Chicago, Tampa, Fla., and Baton Rouge, La.

The dragnet was announced by Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius as the latest in a series of busts over the past four years to crack down on fraud that is believed to annually cost Medicare billions of  dollars.

In all the schemes, profit was a driving force, officials said.

“Today's takedown is the latest sign we are beginning to turn the tide on Medicare fraud,” Sebelius said in a news conference.

Holder said during the four-year crackdown by a federal strike force that 1,500 people have been arrested in connection to schemes involving nearly $2 billion in fraudulent billings.

He claimed that $8 dollars are returned to the U.S. Treasury for every dollar spent on the investigations.

Still, he said the battle against health care fraud is being affected by the across-the-board budget cuts called sequestration, which have trimmed $1.6 billion in funding from the Justice Department in the current fiscal year ending Sept. 30.

"Unless Congress adopts a balanced deficit reduction plan and stops the reductions currently slated for 2014, I fear our capacity to protect the American people from healthcare fraud ... will be further reduced," Holder said.

Sebelius said the Affordable Care Act, widely known as Obamacare, gives the government more tools to combat fraud.

“By expanding our authority to suspend Medicare payments and reimbursements when fraud is suspected, the law allows us to better preserve the system and save taxpayer dollars.” Sebelius said. “Today we’re sending a strong, clear message to anyone seeking to defraud Medicare: You will get caught and you will pay the price. We will protect a sacred trust and an earned guarantee.”

In Miami, where 25 people were charged for their role in various fraudulent schemes totaling $44 million, federal officials allege that in one scheme three suspects bribed Medicare patients for their identification numbers, then used the information to bill the government $20 million for medically unnecessary home health care services.

“The lead defendant spent much of the money from the scheme and purchased multiple luxury vehicles including two Lamborhinis, a Ferrari and a Bentley,” according to a statement from Health and Human Services and the Justice Department.

In Detroit, 18 people, including two doctors, a physician's assistant and two therapists, were charged in various scams totaling some $49 million in false claims for medically unnecessary services, including home health, psychotherapy and infusion therapy.

In one Detroit case, three people allegedly posed as licensed physicians and wrote bogus prescriptions for drugs and psychotherapy services totaling $12 million, according to the HHS-DOJ statement. 

Tuesday’s announcement on the Medicare-fraud sweep was overshadowed by reporters inquiring about two other scandals involving Holder’s Justice Department: That the attorney general’s office seized Associated Press phone records in a probe of a national security leak and a DOJ probe into reports that the IRS gave extra scrutiny to some conservative groups when auditing nonprofit organizations.