Big Bust Sweeps Out Medicare Fraud

Monday, June 22, 2015
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by the Florida Bar in Health Law and Shelby Root

The largest criminal health care fraud takedown in the history of the U.S. Justice Department, in terms of both loss amount and arrests, took place June 18, 2015. The U.S. Department of Justice, along with 900 law enforcement officials, arrested 243 people across the country, including doctors, nurses, and other licensed professionals, for their alleged participation. The individuals have been charged with submitting fake billing for Medicare that totaled approximately $712 million.

Medicare Strike Force teams coordinated an operation in 17 cities with a mission of combating health care fraud, waste, and abuse. U.S. Attorney General Loretta Lynch stated "these are extraordinary figures," and the individuals arrested "billed for equipment that wasn't provided, for care that wasn't needed, and for services that weren't rendered." To see the U.S. Department of Justice's Press Release, click here.
Many Florida Medical Professionals Arrested.
As a result of the raid, Florida became a part of history. It had 73 individuals charged in Miami, and an alleged $263 million in false billings for pharmacy, home health care, and mental health services. In a press conference, Attorney General Lynch stated that one Florida mental health facility billed nearly $64 million between 2006 and 2012 for intensive psychotherapy treatments. It allegedly paid kickbacks to patient recruiters and assisted living facility owners throughout Southern Florida.
Other Florida Cities also had Medicare Fraud.
Miami was not the only city in Florida involved in the fraud arrests. In Tampa, five individuals were charged with participating in a variety of health care schemes. The individuals' participation ranged from fraudulent physical therapy billings to a scheme involving physician services and tests that never occurred. This fraud amounted to millions of dollars. In one instance, a pain management physician sought reimbursement for nerve conduction studies and other services that he allegedly did not perform. Medicare paid the physician over $1 million for these alleged services not performed. To read more on Medicare fraud in Florida, click here.
As Fraud Continues, the Strike Force Vows Not to Stop.

The Department of Health and Human Services Secretary, Sylvia Mathews Burwell, warned: "We will not stop here." She stated: "We will work tirelessly to prevent these programs from becoming targets and fight fraud wherever we find it."

Here are some of our past blogs on Medicare fraud:
1. Court Orders Florida Oncologist to Pay $89.6 Million After False Claims Act Judgment
2. Two South Florida Doctors Sentenced to 10 Years in Prison for Medicare Fraud
3. Medicare Fraud Busts Result in Over 100 Arrests
4. Halifax Health Reaches Record-Setting Settlement in Whistleblower/Qui Tam Fraud Case

What are your thoughts about these large crackdowns on Medicare fraud? Do you think they work as a deterrent for others committing health care fraud? Please leave any thoughtful comments below.
Contact a Health Care Attorney Experienced in the Representation of Medicare and Medicaid Fraud.
The Health Law Firm and its attorneys routinely represent physicians, dentists, orthodontists, medical groups, clinics, pharmacies, assisted living facilities (AFLs), home health care agencies, nursing homes, group homes and other healthcare providers in Medicare and Medicare investigations, audits and recovery actions.

To contact the Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at

The Federal Bureau of Investigation. "National Medicare Fraud Takedown Results in Charges against 243 Individuals for Approximately $712 Million in False Billing." (June 18, 2015). From:
About the Authors: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.
Shelby Root is a summer associate at The Health Law Firm. She is a student at Barry University College of Law in Orlando.
KeyWords: Medicare, Medicare fraud, Medicare investigation, Medicare Strike Force, fraudulent claims, home health care, Medicare overbilling, defense attorney, defense lawyer, Medicare fraud defense attorney, Medicare termination, Medicare exclusions, The Health Law Firm, The Health Law Firm reviews
"The Health Law Firm" is a registered fictitious business name of George F. Indest III, P.A. - The Health Law Firm, a Florida professional service corporation, since 1999. 
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