Good afternoon. Today I’m joined by Department of Health and Human Services Secretary, Kathleen Sebelius; Assistant Attorney General of the Justice Department’s Criminal Division, Lanny Breuer; FBI Associate Deputy Director, Kevin Perkins; HHS Inspector General for Investigations, Daniel R. Levinson; and Deputy Administrator for Program Integrity of the Centers for Medicare and Medicaid Services, Dr. Peter Budetti – to announce a critical step forward in our ongoing fight against health care fraud.
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. Through a series of coordinated, nationwide law enforcement actions, charges have been brought against 91 individuals – including doctors, nurses, and other licensed medical professionals – for their alleged participation in fraud schemes involving nearly $430 million in false billings. That total includes over $230 million in home health care fraud, more than $100 million in mental health care fraud, and approximately $49 million in ambulance transportation fraud. Thanks to the outstanding work of federal authorities – and the assistance of state and local partners – as of today, most of these individuals have been arrested or surrendered.
Charges against these defendants include health care fraud, conspiracy to commit health care fraud, wire fraud, violations of the anti-kickback statutes, aggravated identity theft, and money laundering. These charges are based on a variety of allegedly fraudulent activities involving treatments and services that were either medically unnecessary or, in some cases, never actually rendered – ranging from home health care and mental health services, to psychotherapy, physical and occupational therapy, durable medical equipment services, and the largest ambulance fraud scheme ever prosecuted by the Medicare Fraud Strike Force.
Such activities not only siphon precious taxpayer resources, drive up health care costs, and jeopardize the strength of the Medicare program – they also disproportionately victimize the most vulnerable members of society, including elderly, disabled, and impoverished Americans. And, unfortunately, we allege that many of those charged today not only broke the law – but also violated their professional obligations, and sacred oaths, as medical practitioners. For example, in one case in Dallas, a doctor and two registered nurses are charged with writing more than 30,000 prescriptions for over 2,000 Medicare beneficiaries, resulting in roughly $100 million in fraud. These alleged actions represent an alarming, and unacceptable, nationwide trend – of individuals attempting to exploit federal health care programs – and, collectively, to steal billions in taxpayer dollars – for personal gain.
But we are fighting back. And today’s takedown underscores the fact that federal efforts to combat health care fraud have never been more strategic, more comprehensive, or more effective.
Since the creation of the Health Care Fraud Prevention and Enforcement Action Team – known as “HEAT” – in May of 2009, preventing and shutting down health care fraud schemes has become a top priority – for DOJ and HHS, for the entire Administration, and for our partners at every level of government and across both the public and private sectors. Today’s announcement represents the fifth significant enforcement action taken under HEAT. And there’s no question that this level of commitment is paying dividends.
Joint DOJ/HHS Medicare Fraud Strike Forces are now operating in 9 locations nationwide – in Miami, Los Angeles, Detroit, Houston, Brooklyn, Baton Rouge, Tampa, Chicago, and Dallas. Since the first Strike Force was launched in 2007, these teams have charged nearly 1,500 defendants for falsely billing the Medicare program more than $4.8 billion. And during the last fiscal year, those convicted in Strike Force cases received an average prison sentence of four years.
In addition to disrupting health care fraud schemes and advancing prosecutions, we’re also working to return precious funds to the public coffers – and, since 2009, have been able to recover more than $10.6 billion. Over the same period, for every dollar spent on combating health care fraud, we’ve returned more than seven dollars to the U.S. Treasury, the Medicare Trust Funds, and others.
However, as today’s announcement proves, we are not yet satisfied. And, in the fight against health care fraud, we will never be complacent.
Through HEAT, we’re taking this fight to a new level – by expanding engagement with state, local, and tribal partners; by streamlining federal investigations and prosecutions; and by leveraging resources and expertise. In each of our Strike Force locations, we’re moving aggressively to eradicate health care fraud in all its forms, to strengthen federal health care programs, and to bring the perpetrators of fraud crimes to justice.
I want to thank each of the dedicated investigators, prosecutors, law enforcement officers, and other agency partners whose tireless, collaborative work has made today’s announcement possible – and who stand on the front lines of our efforts to identify and shut down large-scale fraud schemes, like those detailed in the indictments handed down today.
Their actions prove that, despite the size of the challenge we face, progress is possible. And their dedication to this work is sending a clear message to those willing or attempting to commit health care fraud: that we will use every available tool and resource to find you, to stop you, and to punish you to the fullest extent of the law.
At this time, it is my privilege to turn things over to another critical leader in this work – my good friend, Secretary Kathleen Sebelius – who will provide additional information on today’s actions, as well as our efforts to build on this success and to carry this work into the future.