Medicare Fraud Strike Force

The Medicare Fraud Strike Force is a multi-agency team of United States federal, state, and local investigators who combat Medicare fraud through data analysis and increased community policing. Launched in 2007, the Strike Force is coordinated by the United States Department of Justice and the Department of Health and Human Services. It combines the data-analysis capabilities of the Centers for Medicare and Medicaid Services, the investigative resources of the FBI, and the prosecutorial resources of the Department of Justice and the U.S. Attorneys' Offices.[1][2]

Kathleen Sebelius and Eric Holder announced that the Medicare Fraud Strike Force charged 111 defendants in nine cities.
Medicare Fraud Strike Force
Typemulti-agency team
Purposecombat Medicare fraud
Location

The Strike Force operates out of Baton Rouge, Brooklyn, Chicago, Dallas, Detroit, Houston, Los Angeles, Miami, and Tampa Bay.[3] As of May 2013, the Strike Force has charged more than 1,500 people for false billings of more than $5 billion.[4]

Some cases investigated by the Strike Force include the following:

  • In June 2015, more than 240 individuals—including doctors, nurses, and other licensed professionals—were arrested for their alleged participation in Medicare fraud schemes involving approximately $712 million in false billings.[5]
  • In August 2015, a fake hospice nurse who treated more than 200 patients was sentenced to four years in prison.[6]
  • In September 2015, a psychiatrist in Houston was convicted in a fraud scheme amounting to $158 million in a federal criminal trial in Houston, Texas.[7]
  • In September 2016, two psychologists were convicted of health-care fraud, having participated in a $25-million scheme that administered repeated and medically unnecessary tests to nursing-home residents in Mississippi, Louisiana, Florida, and Alabama.[8]
  • In July 2017, Federal officials announced charges against more than 400 individuals—including doctors, nurses, and licensed medical professionals—for their roles in fraud schemes involving about $1.3 billion in false Medicare billings.[9]
  • In April 2019, Federal officials broke up a scam involving orthopedic braces and other durable medical equipment marketed through telemarketing, which doctors would then prescribe to patients regardless of whether they actually needed them. The scam was estimated to have cost Medicare over $1.2 billion. Twenty-four individuals were arrested in six states in connection with the scam.[10]

References
  1. 2011 The FBI Story. United States Government Printing Office. 2012. p. 73. ISBN 978-0160915536.
  2. Levinson, Daniel R. (2010). Health Care Fraud and Abuse Control Program: Annual Report for Fiscal Year 2009. DIANE Publishing. p. 10. ISBN 978-1437935172.
  3. "HEAT Task Force". STOP Medicare Fraud. U.S. Department of Health & Human Services. Retrieved November 28, 2013.
  4. "Medicare Fraud Strike Force Charges 89 Individuals for Approximately $223 Million in False Billing". U.S. Department of Justice. May 14, 2013. Retrieved November 28, 2013.
  5. "Health Care Fraud Takedown: 243 Arrested, Charged with $712 Million in False Medicare Billings". FBI. 18 June 2015.
  6. "Identity Theft: Fake Hospice Nurse Treated More Than 200 Patients". FBI. 8 October 2015.
  7. "Jury convicts Houston psychiatrist in $158 million Medicare fraud scheme". Deer Park Broadcaster. Your Houston News. 14 September 2015. Retrieved 2 October 2015.
  8. Department of Justice Office of Public Affairs (September 7, 2016). "Two Psychologists Plead Guilty in $25 Million Nursing Home-Testing Scheme". Press Release Number 16-1018. United States Department of Justice. Retrieved February 2, 2018.
  9. "Nationwide Sweep Targets Enablers of Opioid Epidemic". Federal Bureau of Investigation.
  10. "Feds break up $1.2 billion Medicare scam that peddled unneeded braces to seniors". CBS News via Associated Press. April 9, 2019. Retrieved May 4, 2019.
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