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Putting an End to Health Care Fraud

Attorney General Eric Holder speaks with 60 Minutes reporter Steve Kroft.

Attorney General Eric Holder speaks with 60 Minutes reporter Steve Kroft.

 Last night 60 Minutes aired "The $60 Billion Fraud" - a detailed look at widespread Medicare and Medicaid fraud schemes that cheats taxpayers out of billons of dollars each year. Attorney General Eric Holder sat down with CBS News and talked about the Justice Department's commitment to put an to end health care fraud. Watch it at CBSNews.com: "The 60 Billion Fraud" The Justice Department's efforts in this area are on-going. Just last week charges and arrests were announced in the cities of Los Angeles and Houston, two centers of activity for the Medicare Fraud Strike Force, the multi-agency squad of investigators and prosecutors that detects billing anomalies, identifies fraud schemes and shuts those schemes down. The charges against 20 defendants in Los Angeles and six defendants in Houston were part of an ongoing crackdown by the Strike Force, which is in turn a vital part of the Health Care Fraud Prevention and Enforcement Action Teams (HEAT), a high-level, anti-fraud partnership of the Departments of Justice and Health and Human Services (HHS). The Los Angeles Strike Force operations involve actions taken against owners of fraudulent durable medical equipment (DME) companies. DME may include wheelchairs, hospital beds, crutches, leg braces and numerous other types of medical devices designed with legitimate assistance purposes in mind. These company owners are alleged to have engaged in a variety of schemes to defraud Medicare through the submission of bills for DME that total approximately $26 million. In some of these alleged schemes, straw owners were paid by defendants to disguise the true ownership of the companies. In some cases, after filing claims to Medicare, those charged allegedly did not supply the equipment to Medicare beneficiaries, supplied equipment to beneficiaries who did not need it, or ordered equipment in the names of deceased beneficiaries. Assistant Attorney General Lanny A. Breuer of the Criminal Division, speaking to reporters, commended the takedown, but said much work remains as Medicare fraud is reigned in:
“Today’s indictments and arrests are important achievements in our ongoing fight against Medicare fraud, but there is more that we can, and will, do. Our Medicare Fraud Strike Force will continue to be vigilant in rooting out criminals who masquerade as health care providers in order to steal from American taxpayers. Every dollar stolen from the Medicare program is one dollar too many.”
Six defendants were charged this week in similar schemes in Houston. In some of the Houston cases, defendants were charged with billing Medicare for DME and then not delivering the equipment to their purported patients. In one case, a defendant is alleged to have billed Medicare for two knee braces for a patient who only has one leg. Since inception in March 2007, Strike Force operations in Los Angeles, Houston, Detroit and Miami have been immensely successful.  The Departments of Justice and HHS are working together to help eliminate fraud and investigate fraudulent Medicare and Medicaid operators who are cheating the system. Attorney General Eric Holder and HHS Secretary Kathleen Sebelius have made a commitment to bring perpetrators of fraud to justice, as demonstrated by the creation of the HEAT earlier this year. Later this week, Assistant Attorney General Tony West will testify before the Senate Judiciary Committee at a hearing on "Effective Strategies for Preventing Health Care Fraud". More information about the hearing is available on the Judiciary Committee Web site, here. To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to www.stopmedicarefraud.gov.
Updated April 7, 2017