Medicare Fraud: 243 People Charged With $712 Million In False Billings

After a nationwide sweep, the government has charged 243 people for Medicare fraud, which involved $712 million in false billings.

At a press conference on Thursday, Attorney General Loretta Lynch and Department of Health and Human Services Secretary Sylvia Mathews Burwell made the announcement. Lynch described the arrests as the largest criminal health care fraud takedown in the history of the Justice Department.

According to the FBI, the arrests began on Tuesday as a part of “a coordinated operation in 17 cities by Medicare Fraud Strike Force teams, which include personnel from the FBI, the Department of Health and Human Services (HHS), the Department of Justice (DOJ), and local law enforcement.”

About 900 law enforcement officials were involved in the cross country sweep, which resulted in the biggest number of arrests in U.S. health care history.

“This action represents the largest criminal health care fraud takedown in the history of the Department of Justice and it adds to an already remarkable record of enforcement,” Attorney General Lynch noted in a statement.

“The defendants charged include doctors, patient recruiters, home health care providers, pharmacy owners and others. They billed for equipment that wasn’t provided, for care that wasn’t needed and for services that weren’t rendered,” she said.

Adding, “In the days ahead, the Department of Justice will continue our focus on preventing wrongdoing and prosecuting those whose criminal activity drives up medical costs and jeopardizes a system that our citizens trust with their lives. We are prepared- and I am personally determined- to continue working with our federal, state and local partners to bring about the vital progress that all Americans deserve.”

The arrested individuals include 46 doctors, nurses, and other licensed medical professionals, Reuters reports. With the charges stemming from a number of fraudulent schemes, including submitting claims to both Medicare and Medicaid for unnecessary treatments and medical care that was essentially not provided.

For instance, a mental health facility billed almost $64 million for psychotherapy sessions that turned out to simply involve moving patients from one location to another.

One other case involved a Michigan doctor who would unnecessarily prescribe narcotics to his patients in exchange for the patients’ identification information, which was then used for the fake billing. These patients then became addicted to the prescribed drugs and found themselves bound to the scheme by the sheer need of accessing these narcotics.


The majority of the arrests were in Florida, an alleged epicenter for Medicare fraud. Miami housed 73 defendants who were charged with false billings of approximately $263 million.

Since the 2007 inception of the Department of Justice and Health and Human Services’ Medicare Strike Force, over 2,300 defendants have been charged with false billing.

These dubious operations were discovered in Miami, Tampa, Houston, Los Angeles, Detroit, Brooklyn, New Orleans, and Dallas and McAllen in Texas, where it was uncovered that the Medicare program was fraudulently billed for over $7 billion.

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