As we have discussed several times on this blog, the federal government, and to a lesser extent the state government, focuses on different types of crimes depending on the prevailing attitudes and issues of the moment. We have seen the government shift its focus from terrorism to mortgage fraud to securities fraud to pain clinics to Medicare fraud. Currently, with the economy and the debt being such major issues, different types of fraud become primary issues for law enforcement. Medicare fraud is a perfect target because it is huge, it involves fraud and it involves stealing from the federal government.
Medicare fraud can take several different forms. One primary way to commit Medicare fraud is to submit Medicare reimbursement forms for medical equipment or medical services that were either never provided or were provided but were unnecessary. The government has no way to track the amount of Medicare fraud with any specificity. However, the government has estimated that the total amount of Medicare fraud in 2010 was close to $50 billion, although it is unclear how many of the cases that comprise that estimate turned out to be valid Medicare reimbursement requests.
The United States Department of Justice (DOJ) recently announced the arrest of 111 suspects for Medicare fraud related conduct. In the press release, the government indicated the arrests included doctors, nurses, health care executives and others in nine cities for Medicare fraud totaling approximately $225 million. The arrests were made by the DOJ’s Medicare Fraud Strike Force which includes hundreds of federal, state and local law enforcement personnel. Confirming the increased focus on Medicare fraud, the DOJ indicated the number of law enforcement officials devoted to making Medicare fraud arrests has quadrupled over the last two years. They claim the various Medicare Fraud Strike Force teams made hundreds of arrests and recovered $4 billion in taxpayer money in 2010.
Of the 111 recent Medicare fraud arrests, 32 of them were in Florida. In Miami, Florida, the police broke up an alleged Medicare fraud scheme that involved $55 million worth of false billings for home health care, medical equipment and prescription drugs.