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Hundreds arrested in largest Medicare fraud crackdown in history

by | Nov 14, 2015 | Health Care Fraud

Federal officials have arrested over 200 people in the largest crackdown on Medicare fraud in U.S. history.

Dozens of Texans among those charged with defrauding Medicare

The federal government has announced charges against 243 people who are suspected of defrauding Medicare, according to the Wall Street Journal. The massive crackdown-the largest in history-is just the latest example of how federal authorities have been increasing their efforts against health care fraud in recent years. Among those arrested include dozens in Texas alone. Officials say the increased focus on Medicare fraud is partly due to the use of new technologies designed to better focus resources on suspected cases of fraud.

Hundreds arrested

The arrests against the 243 people, which include 46 medical professionals, came in mid-June and was described by the Department of Justice as the largest Medicare fraud crackdown in history. Florida saw the most arrests, with 73 in the Miami area alone, while Texas came in second with 29 arrests. In total, the alleged fraud amounted to about $712 million.

Not all of those charged are connected to one another. Federal officials accuse those that have been charged of a variety of offenses, including billing for services or equipment that was never provided or charging for wheelchairs that were not medically necessary. Some of the defendants in Texas were also charged with coaching patients in order to make them appear eligible for certain medical treatments that they were not actually eligible for.

Role of big data growing

The scope of the latest crackdown is largely being attributed to an increased reliance on big data, particularly when it comes to prescription drug fraud, according to Forbes. Prescription drug fraud has been identified as one of the fastest growing areas of health care fraud in the United States. However, new technology is allowing federal authorities to identify potential abuses sooner.

For example, recently the Office of the Inspector General and the federal Department of Health and Human Resources unveiled their report into potential prescription drug fraud occurrences. The report, by analyzing massive amounts of data, allowed federal officials to focus on businesses, such as retail pharmacies and physicians, of either writing or billing for an unusually high number of prescriptions. Such results then allowed investigators to focus their resources on those businesses and individuals who the data suggested were more likely to be involved in fraud.

Fraud defense

As the above story shows, federal and state investigators are becoming increasingly sophisticated when it comes to cracking down on health care fraud. Furthermore, many prosecutors are eager to make an example of those who have been charged by pursuing harsh and lengthy sentences. As such, anybody who has been charged with any type of health care fraud should contact a criminal defense attorney immediately. The right attorney, who is experienced in dealing with fraud and other similar cases, can provide invaluable advice and aggressive representation for clients.