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Health Care Fraud

The Department of Justice recently published the results of their largest takedown on Medicare fraud. Almost 301 individuals were arrested in the process and the total frauds accumulated to approximately 900 million in fraudulent Medicare claims. Medicare Fraud Strike Force, an entity formed with the combined attempts of several federal agencies including DOJ and HHS, led this successful nationwide operation.

The Medicare Fraud Strike Force conducted the operation in 36 federal districts; even though some of them did not have Strike Force offices. Conspiracy to commit healthcare fraud, violations of anti-kickback statutes, money laundering, and aggravated identify theft are the charges registered against the accused. Out of the 301 individuals arrested, the number of doctors was 61, where more than 60 were arrested for Medicare D fraud. Others were charged for false billings, improper home health care, medically pointless mental health services, and pharmacy fraud.

“This takedown should make clear, health care fraud is not an abstract violation or benign offense – It is a serious crime,” Attorney General Loretta Lynch said. Her statement came more as a sentiment, reflecting on the aggravation of HHS and DOJ to take strict measures and counter frauds improper payments in health care.

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Medicare Scam

The increased frauds in Medicare resulted in the formation of Health Care Fraud Prevention & Enforcement Action Team (HEAT) in 2009; an action team determined to hinder the frauds in Medicare with the help of DOJ and HHS. The Medicare Fraud Strike Force program, which successfully arrested hundreds of frauds last month, is a part of HEAT.

As the Medicare Fraud Strike Force was able to analyze and identify emerging frauds in health care, DOJ members praised the efforts of the team and referred the project as a perfect example of law-enforcement agency in this modern era. Furthermore, the Strike Force program is considered as the most cost-effective law-enforcement program today. With the help of the project, the DOJ and federal attorney offices has recovered around $18.3 billion in fraud related to federal health care.

The operating costs of the Medicare Fraud Strike Force is estimated around $10 million per year, and an additional funding of $350 million was donated by ObamaCare to the team, in order to prevent frauds by introducing more Strike Force offices.

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