Federal Government Charges 91 Individuals for Medicare Fraud | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

Federal Government Charges 91 Individuals for Medicare Fraud

October 4, 2012
by Gabriel Perna
| Reprints

The federal government’s push to curb Medicare fraud continued this week when Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius announced that the multi-agency Medicare Fraud Strike Force operations have drawn charges against 91 individuals in seven states – including doctors, nurses and other licensed medical professionals.

The Medicare Fraud Strike Force, which uses federal, state and local investigators and prosecutors to combat Medicare fraud through the use of Medicare data analysis techniques, charged the parties for their alleged participation in Medicare fraud schemes involving approximately $429.2 million in false billing. According to HHS, dozens of charged individuals were arrested or surrendered in the last 24 hours as indictments were unsealed across the country.  Those indictments charge more than $230 million in home healthcare fraud; more than $100 million in mental healthcare fraud and more than $49 million in ambulance transportation fraud; and millions more in other frauds.

“Today’s arrests put criminals on notice that we are cracking down hard on people who want to steal from Medicare,” Sebelius said in a statement.  “The healthcare law gives us new tools to better fight fraud and make Medicare stronger.  In addition to the arrests made today, HHS used new authority from the healthcare law to stop future payments to many of the health care providers suspected of fraud, saving Medicare resources and taxpayer dollars from being lost to fraud in the first place.”

These charges come after Sebelius and Holder’s recent letter to various provider-based organizations, touting the federal government’s resolve to prevent EHR-related healthcare fraud. In the letter, Sebelius and Holder note that there has been “troubling indications” that some providers are using EHRs to “game the system,” and obtain payments, which they are not entitled.

The American Hospital Association (AHA), one of the targets of the original letter,responded and urged HHS to work with the hospital association to quickly develop national guidelines for the coding of emergency department and medical clinic visits.  There has also been public attention on the issue of potentially abuse coding in that area, as highlighted by a recent New York Times investigative report on the topic.

Get the latest information on Health IT and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.

Learn More

Topics

News

Trump will Nominate Acting VA Secretary Wilkie for Permanent Position

Just a day after the Department of Veterans Affairs (VA) and Cerner inked their $10 billion EHR (electronic health record) deal, President Trump said he would be nominating Acting VA Secretary Robert Wilkie for the permanent position.

ONC Names API Server Showdown Stage 2 Winner

The Office of the National Coordinator for Health Information Technology (ONC) has named 1UpHealth as the Stage 2 winner of the “Secure API Server Showdown” challenge.

EHNAC Developing Trusted Exchange Accreditation Program

To align with the Trusted Exchange Framework and Common Agreement, the Electronic Healthcare Network Accreditation Commission, a nonprofit standards development organization and accrediting body, is working with other organizations to establish a new Trusted Exchange Accreditation Program.

Lawmakers Demand New VA CIO, Citing “Malign Neglect” on EHR Project

A group of Democratic federal lawmakers, five senators and six members of Congress, are calling out the U.S. Department of Veterans Affairs (VA) for what they call “malign neglect” in the agency’s efforts to achieve electronic health record (EHR) modernization.

Medical Record Access Proves Costly for Some Patients, GAO Report Finds

Federal law requires healthcare providers to give patients access to their medical records, but according to a new GAO report, some patients believe they’re being charged too much to access their records.

Parkland’s Innovation Bridge Takes ‘Genius Bar’ Approach to Digital Health Apps

Taking inspiration from the Apple Genius Bar and Ochsner Health System’s O Bar, the Dallas-based Parkland Center for Clinical Innovation in collaboration with Parkland Health & Hospital System has opened an “Innovation Bridge” to assist patients with health-related apps.