July 25, 2010

Doctors, nurses joined Medicare scam, U.S. says

U.S. authorities charged 94 doctors, nurses and clinic owners with scheming to defraud the taxpayer-funded Medicare program out of $251 million, Attorney General Eric Holder said on Friday.

He said 36 defendants had been arrested so far in five cities in "the largest federal healthcare fraud take-down in our nation's history."

The suspects submitted false claims for equipment and services that were not medically necessary and in many cases not actually provided, Holder said. The claims were filed through the Medicare program that provides healthcare to elderly and disabled Americans.

"These criminals have siphoned resources from the most vulnerable among us," Holder said, referring to suspects in Miami, Detroit, New York, Houston, and Baton Rouge, Louisiana.

"With today's arrests, we're putting would-be criminals on notice: Healthcare fraud is no longer a safe bet. It's no longer easy money," Holder told a news conference in Miami.

The sweeping healthcare overhaul that President Barack Obama and his fellow the Democrats pushed through Congress in March relies partly on cutting waste and fraud to help offset the expansion of government-subsidized healthcare for more than 30 million uninsured Americans.

Fraud bleeds $60 billion a year from the Medicare program and South Florida is regarded as the national epicenter, accounting for a third of U.S. healthcare fraud prosecutions. That is partly because of the region's large population of elderly people and of non-English speakers, prosecutors have said.

Those charged on Friday included doctors, nurses, clinic owners and administrators and recruiters who persuaded patients to let their names be used on the claims.

"A lot don't understand how valuable their Medicare ID information is," said Department of Health and Human Services Secretary Kathleen Sebelius.

She said the government is working to educate people to better protect the information. It is also consolidating various Medicare data banks and using analytical tools similar to those used by credit card agencies to find suspicious billing patterns before claims are paid, Sibelius said.

Holder and Sibelius were in Miami on Friday for a healthcare fraud summit, the first of a series planned for other large U.S. cities.

More than 360 law enforcement agents from various federal, state and local agencies took part in the crackdown announced on Friday, Holder said.

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