Medicare fraud bust nabs Detroit providers

Schemes involve never rendered home care, kickbacks

The Medicare Fraud Strike Force has charged 20 Detroiters with bilking Medicare out of more than $34 million by filing fraudulent claims for physician home visits, home and outpatient healthcare, and chiropractic and psychotherapy services, the U.S. Department of Justice announced Thursday.

The defendants in six lawsuits include doctors, clinic owners, office staff and patient recruiters, according to the DoJ.

Court documents unsealed last week charge defendants with claiming payment for services not provided and participating in kickback schemes. These involved paying doctors to certify beneficiaries for unnecessary home care, supplying patients with desired narcotics in exchange for use of their insurance identification numbers and paying marketers to recruit people for unnecessary services. For chiropractic and psychotherapy claims, the complaint alleges defendants obtained licensed practitioners' provider numbers and used them to bill for services never supplied.

"These charges clearly send the message to criminals that committing fraud against government healthcare programs puts them squarely in the sights of the Medicare Fraud Strike Force," said U.S. Department of Health & Human Services-Office of Inspector General Special Agent in Charge Lamont Pugh III in the DoJ announcement. "Taxpayers and patients should know that OIG with its Strike Force partners will continue to root out, expose and hold accountable those who attack the Medicare Program."

Fraud fighting is a core component of OIG's strategic plan, as FierceHealthPayer previously reported, and the Government Accountability Office considers Medicare a high-risk fraud target due to its complexity and size.

Medicare Fraud Strike Force activities are part of the Healthcare Fraud Prevention & Enforcement Action Team (HEAT), a program integrity collaboration between DoJ and HHS. Since 2007, the strike force has charged more than 1,700 offenders who collectively billed more than $5.5 billion in fraudulent Medicare claims, the DoJ noted.

For more:
- read the DoJ announcement

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