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Massive Healthcare Fraud Takedown

Posted in Affordable Care Act, Fraud and Abuse, HIPAA and the HITECH Act, Home Healthcare, Hospitals and Institutions, Legislation and Public Policy, Litigation, Medicare and Medicaid, Pharmaceuticals, White Collar

Day Pitney’s July 2016 White Collar Roundup included the following item:

Massive Healthcare Fraud Takedown

U.S. Attorney General Loretta E. Lynch and Department of Health and Human Services Secretary Sylvia Mathews Burwell announced that the Medicare Fraud Strike Force (MFSF) arrested approximately 300 people, including 61 doctors, nurses and other licensed medical professionals, in 36 federal districts. The cases relate to alleged healthcare fraud, including violations of anti-kickback statutes, money laundering and aggravated identity theft. The schemes allegedly involved the filing of false Medicare and Medicaid claims for services that were either unnecessary or never provided. Further, patient recruiters were allegedly paid kickbacks for supplying beneficiary information to providers to allow for the fraudulent claims to be submitted. The government alleges the schemes were responsible for approximately $900 million in fraudulent billing. Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division called the MFSF “a model of 21st-Century-data-driven law enforcement” that “has had a remarkable impact on healthcare fraud across the country.” For an article on the takedown, click here.

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