Baton Rouge among cities targeted in feds' biggest Medicare bust

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Baton Rouge among cities targeted in feds' biggest Medicare bust

* By KELLI KENNEDY feedback@...>

* Associated Press writer

* Published: Jul 16, 2010 - UPDATED: 9:12 a.m.

*

* http://www.2theadvocate.com/news/98600484.html##>

MIAMI (AP) - Federal authorities said Friday they are conducting the

largest Medicare fraud bust ever in five different states and arrested

dozens of suspects accused in scams totaling $251 million.

Several doctors and nurses were among those arrested in Miami, New York

City, Detroit, Houston and Baton Rouge, accused of billing Medicare for

unnecessary equipment, physical therapy and HIV treatments that patients

typically never received. Ninety-four suspects were indicted, and

authorities said 36 people had been arrested as of Friday morning.

More than 360 agents participated in Friday's raids, announced by

Attorney General Holder and Health and Human Services Secretary

Kathleen Sebelius at a health care fraud prevention summit in Miami.

Officials said they chose Miami because it is ground zero for Medicare

fraud. Authorities indicted 33 suspects in the Miami area, accused of

charging Medicare for about $140 million in various scams.

" With today's arrests we're putting would-be criminals on notice: health

care fraud is no longer a safe bet, " Holder said Friday.

Cleaning up an estimated $60 billion to $90 billion a year in Medicare

fraud will be key to paying for President Barack Obama's proposed health

care overhaul. Federal officials have promised more money and manpower

to fight fraud, setting up strike forces in several cities.

Around the country, the schemes have morphed from the typical medical

equipment scam in which clinic owners billed Medicare dozens of times

for the same wheelchair, while never giving the medical equipment to

patients. Now, officials say, the schemes involve a sophisticated

network of doctors, clinic owners, patients and patient recruiters.

Violent criminals and mobsters are also tapping into the scams, seeing

Medicare fraud as more lucrative than dealing drugs and having less

severe criminal penalties, officials said.

For instance, agents bugged a medical center in Brooklyn, N.Y., where

eight people are charged with running a $50 million scam that submitted

bogus claims for physical therapy. Clinic owners paid patients,

including undercover agents, in exchange for using their Medicare

numbers and a bonus fee for recruiting new patients. Recording devices

captured hundreds of kickback payments in a private room where a man sat

at a table and did nothing but pay patients all day, authorities said.

In a separate Brooklyn case, authorities indicted six patients who

shopped their Medicare numbers to various clinics. More than 3,744

claims were submitted on behalf of one woman in the past six years. The

patients did not receive the services billed to Medicare, authorities

said.

" Today's arrests illustrate how health care fraud schemes can replicate

virally and migrate rapidly across communities, " said R.

Levinson, inspector general of the U.S. Department of Health and Human

Services, which oversees Medicare.

Federal authorities launched a strike force in Miami in 2007 to target

the problem. The program has since expanded to seven cities and is

responsible for more than 720 indictments that collectively have billed

the Medicare program for more than $1.6 billion.

Miami-Dade County received about $520 million from Medicare in home

health care payments intended for the sickest patients in 2008, which is

more than the rest of the country combined, according to a federal

report. Only 2 percent of the patients live here.

It used to take 90 days before the government detected a scam. By then,

the crooks were long gone, sometimes with millions of dollars. Now

authorities get billing data as it's submitted, allowing them to catch

suspects in real time, " as opposed to the typical pay and chase model

we've had for years, " said Gerald Roy, assistant inspector general for

investigations.

Les

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