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Feds Charge 200 With Health Care Fraud

By Jeralyn, Section Crime in the News
Posted on Thu Jun 18, 2015 at 11:58:56 AM EST
Tags: health care fraud (all tags)
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New Attorney General Loretta Lynch today announced a major bust: 200 people nationwide have been charged with fraudulently billing medicare and other related crimes.

The total amount of alleged fraud exceeds $700 million. 46 of those charged are doctors and health care professionals. Lynch says it's the largest health care fraud case in DOJ history.

The suspects are accused of scams ranging from identity theft to money laundering and conspiracy to commit health-care fraud. Dozens of those arrested were charged with defrauding the Medicare prescription-drug program, officials said.

James Comey said the FBI has 2,700 pending health care fraud investigations.

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    Feds Charge 200 With Health Care Fraud | 24 comments (24 topical)

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    One of my doctors continually (5.00 / 1) (#1)
    by fishcamp on Thu Jun 18, 2015 at 12:23:31 PM EST
    puts down the word long,  after every appointment, and they are no longer than any of the other doctor's appointments.  He then bills $80 more than any of the others.  I have often wondered if  this is a tiny form of Medicare fraud.  Have any of you had this happen?

    Yes. The last routine derm. appontment (5.00 / 1) (#2)
    by oculus on Thu Jun 18, 2015 at 12:42:24 PM EST
    was billed as "complex."  But it wasn't.

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    You must have (none / 0) (#3)
    by nycstray on Thu Jun 18, 2015 at 12:47:07 PM EST
    Asked a question . . .

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    This is very good news (5.00 / 4) (#21)
    by Peter G on Thu Jun 18, 2015 at 08:27:08 PM EST
    for us private defense lawyers. Numerous new clients with money, to balance out and subsidize our pro bono and court-appointed work. Thank you, DOJ.

    Thank you for caring for the poor Peter! (none / 0) (#22)
    by Militarytracy on Fri Jun 19, 2015 at 12:38:46 PM EST


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    Seriously, most of the higher-priced (5.00 / 1) (#23)
    by Peter G on Fri Jun 19, 2015 at 07:40:50 PM EST
    "white collar" defense lawyers I know take a fair share (some more than others, of course) of court-appointed cases. Those are clients who have been found eligible for a public defender, but the defender office is over-loaded or has a conflict of interest that prevents them from taking that particular client.

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    Medical rackets today... (none / 0) (#4)
    by kdog on Thu Jun 18, 2015 at 12:48:31 PM EST
    finance rackets when?  

    Don't get me wrong, this brand of white collar crime is a good use of DOJ resources.  But it still pales in comparison to the financial rackets crime spree that has been running strong since forever, and on steroids since the 80's.

    I hope AG Lynch tackles that one in a big way, she could literally do nothing else while AG and we'd be better for it.  I know the lawbooks are a hurdle, as much of the thievery and fraud we've some to know has been legalized and sanctioned, but it's the number one crime problem in America and surely there are a few weapons left in the armory for her to use.  If Obama will let her...

    Aside...I just found out last night I'm only 3 degrees of separation away from our new AG.  One of my best friends used to work with her husband in the TV business and they're still friendly.  Kinda scary as my friend is in her husbands phone, and I'm in his phone...should I worry? ;)

    Yes. You are moving target. (5.00 / 1) (#5)
    by oculus on Thu Jun 18, 2015 at 12:51:20 PM EST


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    Me and the rest of the greater... (5.00 / 1) (#6)
    by kdog on Thu Jun 18, 2015 at 01:00:40 PM EST
    NYC area...federal pig attention would be new;)

    I told my pal to tell AG's spouse to tell AG to cease and desist all federal marijuana investigations and prosecutions, and to put up the crime scene tape at the Exchange...double post haste!  I ain't going down without some last requests.

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    Was it wise to direct attention (none / 0) (#11)
    by oculus on Thu Jun 18, 2015 at 02:09:55 PM EST
    to yourself?

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    I thought she did very well speaking (none / 0) (#15)
    by Militarytracy on Thu Jun 18, 2015 at 03:21:27 PM EST
    On the latest hate crime shooting.  My husband said he already likes her better than Holder. I guess based on her public persona or something.

    I thought the President spoke well too today, and in my bias wonder if Gov. Haley's tears were as authentic as we all hope because she pushed big to make handgun ownership less restricted and signed that legislation in 2014.

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    But if you are in Kdog's phone (none / 0) (#13)
    by Militarytracy on Thu Jun 18, 2015 at 03:15:49 PM EST
    Doesn't that help negate the need to eyeball him :)?

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    OMG! (none / 0) (#20)
    by oculus on Thu Jun 18, 2015 at 07:34:08 PM EST


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    "...cease and desist (none / 0) (#7)
    by KeysDan on Thu Jun 18, 2015 at 01:25:25 PM EST
    all federal marijuana investigations and prosecutions, and to put up the crime scene tape at the Exchange..."  

    Elusive for the former, illusive for the later.

    Here's a link to the story you can read (none / 0) (#8)
    by Mr Natural on Thu Jun 18, 2015 at 01:44:43 PM EST
    if, like me, you've already blown through your month's allotment of free glimpses at the Wall Street Journal.   Here it is on the Daily Mail.  

    Googling Detroit Medicare fraud will bury you in an avalanche of hits and many different cases.  In 2008 or 09 the DOJ began targeting Detroit and eight other cities.  They've been doing a land office business.

    There was a case recently in the Detroit area of a doctor whose cancer treatment clinics overbilled by between $80M and $225M.  I've read both numbers in the various stories about this case over several years.  If I weren't so lazy I'd dig out the charging dox on the local DOJ website, which is where I stumbled over the resolution of the case while googling to see if any more of ex Mayor Kilpatrick's cronies had been convicted.  (One or two had.)

    Ok.  I'm not so lazy.  The DOJ press release on the Doctor's guilty plea.  His sentencing hearing is in July.  lol; Even the FBI issued a press release when they arrested him.  It lists a still different amount for the fraud, $35M.

    This is unreal.  Dr. Fata's journey through the system resembles a blog on the Detroit DOJ's PR page.

    Details on today's local Detroit indictments (none / 0) (#9)
    by Mr Natural on Thu Jun 18, 2015 at 01:53:49 PM EST
    here.  There was even a count of "structuring" in the middle of that muddle.


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    Mr. Natural, (none / 0) (#14)
    by fishcamp on Thu Jun 18, 2015 at 03:16:33 PM EST
    delete your Wall Street Journal cookies, if you can find them.  I think the big newspapers are camouflaging their cookies these days.  But I'm sure you know this routine.  Sometimes I get mad and delete all my cookies.  It does take a bit longer to load some sites for a while, but they all find you again very fast.

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    I delete all the cookies on my computer (5.00 / 1) (#16)
    by caseyOR on Thu Jun 18, 2015 at 03:32:25 PM EST
    at least once a month. The worst that happens when I do that is that my bank and credit card company throw a couple of security questions at me the first time I log on to their sites after tossing the cookies.

    For me deleting cookies is a computer housekeeping issue. It is important to throw out all the junk around you on a regular basis.

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    I clear my (none / 0) (#17)
    by Zorba on Thu Jun 18, 2015 at 04:28:53 PM EST
    cookies and my history once a week.  
    Answering the security questions is not that big a deal.


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    It's good that are cracking down (none / 0) (#10)
    by sj on Thu Jun 18, 2015 at 01:55:48 PM EST
    on Medicare fraud. That is $700 million that could have been put to better use.

    Now if they could just do the same to the banksters...

    Yes, it is good. (5.00 / 1) (#24)
    by NYShooter on Fri Jun 19, 2015 at 08:43:33 PM EST
    $700 million is a lot of money.

    However, The New York Stock Exchange opens at 9:30 a.m. every weekday morning; By 9:35 a.m. the $700 million they've already stolen hardly warrants a blip.

    Doctors are pikers; they steal millions. The Wall Street Boys & The Banksters count their theft by Trillions.

    As Assistant Attorney General Lanny Breuer always says, after announcing the "successful" prosecution of a TBTF Bank,(paraphrasing,) We felt that a monetary penalty for, let's say, HSBC Bank was justified because getting criminal convictions for, admitted, laundering of drug kingpin & terrorist Billions is just, well, hard.

    Yes, Too Big To Fail is also, Too Big To jail.  

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    This story is evidence (none / 0) (#12)
    by Chuck0 on Thu Jun 18, 2015 at 02:25:47 PM EST
    why we don't need a single-payer health care system. We need a no-payer system. Create a national health service based on a military model. Pay doctors a government salary, no medical billing, just provide healthcare.

    I grew up with government health care. It was called the US Navy Medical Corp. Excellent care, no medical billing. Why can't the US create a similar medical corp using the Public Health Service as a starting point? Build clinics, hospitals, etc. all staffed with medical corp personnel. No insurance model, no billing the government creating waste and fraud.

    Problem with govt takeover (none / 0) (#18)
    by ragebot on Thu Jun 18, 2015 at 05:03:12 PM EST
    is that it will never be complete.  There would always be doctors who provide care on a fee for service basis.  It should not shock anyone that the best doctors would be the most in demand and many would want to be in the fee for service model since they would make more money there.

    I really can't see how the govt would be able to force all doctors into govt jobs, or even set prices for that matter.

    The end result would be a tiered system with the best doctors getting paid the most by private fee for service and the worst care provided by the govt system.

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    There is already a tiered system (none / 0) (#19)
    by Zorba on Thu Jun 18, 2015 at 06:58:53 PM EST
    It's called by various names, and the plans have some differences.
    Concierge medicine, retainer medicine, direct primary care.

    Link.

    As you can see from the link, they are not all exactly the same in what they charge and the medical services you get, but they all charge some kind of annual (or quarterly, or monthly) fee.


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    Feds Charge 200 With Health Care Fraud | 24 comments (24 topical)

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