Strike Force Targets Medicare Fraud By Los Angeles Area Health Care Companies

Eleven people have been indicted in the second phase of a targeted criminal, civil and administrative effort against individuals and health care companies that fraudulently bill the Medicare program, Assistant Attorney General of the Criminal Division Alice S. Fisher and U.S. Attorney for the Central District of California Thomas P. O’Brien announced today.

The indictments in the Central District of California resulted from the creation of a multi-agency team of federal, state and local investigators designed specifically to combat Medicare fraud through the use of real-time analysis of Medicare billing data. The first phase of the strike force began operating in Miami-Dade County on March 1, 2007, and has secured more than 100 convictions to date related to fraudulent Medicare billing.

Since phase two of strike force operations began in Los Angeles on March 1 of this year, the strike force has obtained indictments of individuals and organizations that collectively have made almost $13 million in fraudulent claims to the Medicare program. Charges brought against the defendants in these indictments include conspiracy to commit health care fraud, advising or participating in a scheme to defraud a health care benefit program and aggravated identity theft. If convicted, many of the defendants face up to ten years in prison. All indictments also seek forfeiture of the criminal proceeds.

On May 8, federal agents executed four search warrants, two seizure warrants and arrested 10 people in the first round of arrests resulting from phase two of the Medicare Fraud Task Force. Defendants taken into custody were arrested for submitting false claims to the Medicare program for wheelchairs, orthotics and other DME that was medically unnecessary and/or not provided to the beneficiaries identified in claims. All defendants were owners and operators of medical supply companies in the Los Angeles area.

“Working closely with important federal, state and local law enforcement partners in Los Angeles, we have now successfully replicated the Medicare Strike Force initiative that was first used last year in Florida,” said Daniel R. Levinson, Inspector General for the Department of Health and Human Services. “This collaborative enforcement model is an effective way to direct investigative resources toward illegal activities and preserve the integrity of the Medicare program.”

On May 9, 2007, the Miami Strike Force was publicly announced, following the arrest of 28 defendants by FBI and U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) agents the previous day. Phase one of strike force operations in Miami-Dade County which ran from March 1 to Sept. 30, 2007, led to the indictment of 130 individual defendants in 76 cases, resulting in 101 convictions to date.

Eleven convictions resulted from jury verdicts, 90 convictions came as the result of pleas, 13 individuals remain fugitives and the remainder of the130 defendants are awaiting trial.

In Miami, fraudulent billings to Medicare in strike force-related cases have exceeded $420 million, including $209 million billed in fraudulent DME claims. To date, convicted defendants have been sentenced to more than $51 million in court-ordered restitutions, fines and/or forfeitures related to Medicare losses.

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