Strike Force Busts 89 Scammers in Massive Medicare Fraud Takedown

At least three home health agencies were busted in a nationwide Medicare Fraud Strike Force takedown of 89 people in eight cities for their alleged roles in submitting about $223 million in bogus charges to the taxpayer-funded program, the Department of Health and Human Services (HHS) and Department of Justice announced on Tuesday. 

The indictments occurred in Miami, New Orleans, Houston, Los Angeles, Detroit, Tampa, Chicago, and Brooklyn as part of the Strike Force’s sixth national Medicare fraud takedown. 

Miami has remained a hotbed for Medicare fraud, as 25 defendants—including two nurses, a paramedic, and a radiographer—were charged Monday and Tuesday for their participation in various fraud schemes involving a total of $4 million in false billings for home health care, mental health services, occupational and physical therapy, DME, and HIV infusion. 

In just one Miami case, three defendants were charged for participating in a $20 million home health fraud scheme involving a home health agency called Trust Care Health Services. 

The defendants bribed Medicare beneficiaries for their Medicare information, according to court documents, and then used that information to bill of rhone health services that were not rendered or that weren’t medically necessary. The lead defendant spent much of the money obtained from the scheme, purchasing multiple luxury vehicles including two Lamborghinis, a Ferrari, and a Bentley, according to the DOJ.

Meanwhile, the Baton Rouge Strike Force charged 11 individuals for participating in other fraudulent schemes. Five individuals were charged Tuesday in New Orleans for participating in a $51 million home health fraud scheme. 

The defendants are charged with recruiting beneficiaries, offering cash and other incentives, in exchange for their Medicare information which was then used to bill medically unnecessary home health services. 

In Houston, two more individuals, a nurse and a social worker, were charged with fraud schemes involving a total of $8.1 million in false billings for home health care. The brother-sister duo allegedly used patient recruiters to obtain Medicare beneficiary information they then used to bill for services that either were not rendered or were not medically necessary.

Another 13 defendants were charged in Los Angeles for their roles to defraud Medicare of about $23 million in a kickback scheme, while 18 defendants—including two doctors, a physician’s assistant, and two therapists—were charged in Detroit for their roles in defrauding Medicare to the tune of $49 million in false claims for medically unnecessary services, including home health, psychotherapy, and infusion therapy. 

Nine more individuals were charged in Tampa for a variety of schemes ranging from pharmacy fraud to health care-related money laundering. Seven more individuals were charged in Chicago, including two doctors, for a variety of health care fraud schemes, and another four were charged in Brooklyn for their roles in fraud schemes involving $9.1 million in false claims. 

So far, nearly 600 individuals have been charged in connection with schemes involving almost $2 billion in fraudulent Medicare billings through the Medicare Fraud Strike Force’s six national takedowns. Since the team was created in March 2007, it has charged more than 1,500 defendants who collectively have falsely billed the Medicare program for more than $5 billion. 

“We can all be proud of this remarkable progress.  We should be encouraged by the significant actions we announce today,” said Attorney General Eric Holder in a Tuesday speech.  “But we cannot yet be satisfied.”

Written by Alyssa Gerace

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