Health Law Alert: Massive Criminal Takedown Is Latest Salvo in Government's Intensified Campaign Against Health Care Fraud and Abuse

Baker Donelson
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On May 2, 2012, the Justice Department and the U.S. Department of Health and Human Services (HHS) announced a nationwide takedown of 107 individuals for Medicare fraud schemes involving approximately $452 million in false billings. The wave of indictments were the culmination of the Medicare Fraud Strike Force's investigation of illegal schemes orchestrated by various health care workers, including doctors, nurses, and social workers in Baton Rouge, Chicago, Detroit, Houston, Los Angeles, Miami, and Tampa. Fifty-nine of the defendants were indicted in Miami for their involvement in a scheme to defraud Medicare of $137 million in false billings for home health care, mental health, and other services. Seven individuals were accused of submitting $225 million in false claims through two community mental health centers located in Baton Rouge — the largest-ever prosecution involving such institutions. The accused face a range of criminal charges, including health care fraud, conspiracy to defraud the Medicare program, money laundering, and violations of the antikickback statute. In addition, administrative action was taken against 52 providers pursuant to authority recently afforded by the Affordable Care Act that permits HHS to suspend payments until the completion of an investigation.

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