DOJ indicts 32 for alleged Medicare fraud

[JURIST] The US Department of Justice (DOJ) and Department of Health and Human Services [official websites] on Wednesday announced the indictment [case summaries, PDF; press release] of 32 for allegedly filing $16 million dollars in fraudulent Medicare [official website] claims. According to the indictment, those involved in the scheme submitted claims for arthritis devices and nutrition packages that we either medically unnecessary or were never delivered to patients. The investigation that led to the indictments was conducted by the multi-agency Health Care Fraud Prevention and Enforcement Action Team (HEAT) [official website] that was announced [press release] in May. Officials say that reducing Medicare fraud is necessary to the financial health of the program.

Last month, the DOJ announced the indictment [press release; JURIST report] of 53 health care providers and beneficiaries accused of submitting $50 million in fraudulent claims. In October, the US Centers for Medicare and Medicaid Services (CMS) [official website] implemented regulations [text] denying hospitals payment for treating conditions caused by some common medical errors [HHS backgrounder]. The new regulations were authorized by the Deficit Reduction Act of 2005 [text], which directed the HHS to identify reasonably preventable conditions that result in high-cost or high-volume treatment and additional government payments.

 

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