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Detroit: One of the Top Cities for Medicare Fraud

Medicare Fraud Targeted by Strike Force

Medicare Fraud Targeted by Strike Force

In 2007, the Medicare Fraud Strike Force was formed. According to the Office of Inspector General, the Medicare Fraud Strike Force uses data analytics and resources from the Federal, State, and local law enforcement to prevent and tackle health care fraud, waste, and abuse.

The Strike Force is located in nine cities that include Miami, Florida; Los Angeles, California; Detroit, Michigan; southern Texas; Brooklyn, New York; southern Louisiana; Tampa, Florida; Chicago, Illinois; and Dallas, Texas.

In an article by the National Public Radio, since the Strike Force has been formed, they have charged over 2,300 defendants. Those defendants as a collective have falsely billed out of 7 billion dollars.

Earlier This Month

Earlier this month, Federal agents arrested doctors, nurses, and other medical professions who have been accused of totally up over 700 million dollars in false Medicare billings.

According to an article be the National Public Radio, Attorney General Loretta Lynch called it,

“The largest criminal health care fraud takedown in the history of the Department of Justice.”

Two-hundred and forty-three people were arrested throughout the United States. Charges include fraud, money laundering, aggravated identity theft, and kickbacks.

It took 3 days to arrest the 243 medical professionals in 17 cities.

Medicare Fraud in Detroit

During the sweep, 16 people in greater Detroit were arrested. The arrested included six doctors, a social worker, a pharmacists, and two physical therapists. They charged a total of $122 million dollars in health care fraud and kickback schemes.

According to the Detroit Free Press, the allegations include:

  • Submitting medically unnecessary fraudulent claims for services or not providing those services.
  • Referring patients who are not homebound to home health care.

U.S. Attorney Barbara McQuade was quoted stating,

“Health care fraud has been pervasive throughout metro Detroit in recent years, at great cost to the American taxpayer. We hope that cases like these will alert doctors, pharmacists and other providers that criminal investigators are now scrutinizing billing records so that we can detect fraud and hold wrongdoers accountable.”

Detroit and Medicare Drug Fraud

Over 1,400 pharmacies nationwide were found by the Health & Human Services Department to have suspicious billings in 2014. These pharmacies tend to be independently owned and most often in the metro areas of Detroit, New York, Miami, and Los Angeles.

In an article recently published by the Detroit News, we learn that Detroit is one of the top four cities for “questionable billing practices in Medicare’s prescription drug program last year.” These questionable billings were described as:

“Including hundreds that billed “extremely high” numbers of prescriptions per Medicare patient and others billing for nearly three times the national average of commonly abused narcotics in 2014.”

Those prescription painkillers are highly addictive and according to the National Institute on Drug Abuse, affect 2.1 million Americans.

The state of Michigan’s rate of opiate overdose is 17.6 deaths per 100,000. That national average is 12.8 per 100,000.

Summary

Beginning in 2009, the Department of Justice starting targeting a specific region in Michigan for Medicare fraud. Since then, there have been charges filed against 381 people with a total of $881 million 1 dollars in false billing in the Eastern District of Michigan.

If someone you know is facing Medicare fraud charges, having an experienced criminal defense attorney will be key. If you have any questions, please contact my office. I am here to help.

248-348-7400 or 586-530-1000

This article was published on: June 26, 2015 and was last modified June 26, 2015