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Friday, January 15, 2021

Feds charge $900 million in fake medical bills, kickbacks and other health care fraud; North Texas doctor indicted

The Justice Department announced Wednesday it had charged a record 301 people with schemes that defrauded government health programs by submitting $900 million in fraudulent health claims.

The announcement of the charges, called the largest takedown for Medicare and Medicaid fraud in history, was the result of a nationwide sweep that exposed alleged kickbacks, embezzlement and fake claims to the government programs that provide health care for the elderly and the poor. The allegations involved various kinds of fraud in diverse areas of health care, ranging from prescription drugs to home health care to physical therapy.

“They submitted dishonest claims, they charged excessive fees and they prescribed unnecessary drugs,” Attorney General Loretta Lynch said at a news conference. “As this takedown should make clear, health-care fraud is not an abstract violation. It’s not a benign offense. It’s a serious crime.”

The Justice Department called the sweep “unprecedented” in a press release. Last year, 243 people were charged with $712 million in false claims.

Among the alleged fraud uncovered:

– A Texas doctor certified patients for home health care that was not necessary; then home health care companies billed Medicare for $23.3 million based on those certifications. According to the indictment, a medical doctor, Hector Molina of Irving, operated three facilities, including Park Row Medical in Arlington and used those facilities for the fraudulent billings.

– A California physician who performed unnecessary vein ablation procedures was charged with $12 million in fraudulent billing.

– In Florida, the owner of clinics that deliver infusion drugs was accused of submitting reimbursement claims for expensive drugs that were never purchased or given to patients.

– In Michigan, owners of two physical therapy clinics were accused of submitting claims to Medicare after patients had died and fabricating imaging reports to build a false medical case for prescribing painkillers and physical therapy visits.

More than 60 people were charged with fraud related to the prescription drug benefit portion of Medicare.

The Medicare Fraud Strike Force began its work in 2007 and has charged more than 2,900 people with health-care fraud, who have billed Medicare for $8.9 billion.

For more information on the indictments: www.justice.gov/opa/documents-and-resources-june-22-2016-medicare-fraud-strike-force-press-conference

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