Federal authorities have charged 300 doctors and clinic owners with fraud under the biggest Medicare clampdown in history, officials announced Wednesday.
The defendants allegedly billed Medicare for fraudulent claims that either weren’t provided or not medically necessary. Some are accused of running scam operations by bribing patients to get services in exchange for narcotics. All together, they billed the federal health insurance program $900 million.
While the Department of Justice has been ramping up its enforcement efforts over the past few years, this year’s crackdown far exceeds what the agency has accomplished in any year past. In 2015, the DOJ charged 243 providers with $712 million in billings. Thirty-six federal districts are involved in the prosecution, compared to 17 last year.
In one case, outpatient clinic owners Shirley Douglas and Malik Fuqua submitted $36 million in claims for physical therapy and other Part B services that they didn’t provide to patients. Instead, they recruited the patients in exchange for prescriptions for controlled substances or pain medications.
In another example provided by the DOJ, Houston doctor John Ramirez conspired with dozens of home health companies to authorize services for hundreds of Medicare patients that either weren’t necessary or not provided at all. The agency said that 50 percent of the cases in this year’s takedown involve some kind of home health fraud.
Attorney General Loretta Lynch, Health and Human Services Secretary Sylvia Mathews Burwell and other federal law enforcement officials made the announcement Wednesday morning.
