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The FBI analyzed billing data to find areas in the country where there is a high potential for fraud.
The nationwide sweep included Florida, Texas, California, Louisiana, New York and Michigan. The sweep includes a variety of fraud schemes ranging from anti-kickback violations, aggravated identity theft, and conspiracy to commit healthcare fraud involving home health, mental health, occupational therapy, durable medical equipment and pharmaceutical fraud.
Federal authorities began investigating Maxima about a year ago after a confidential informant told them that Givens had been paying people for referrals for home health care services and "billing Medicare services that were not medically necessary and/or not provided", the complaint says. Included in the press conference were FBI Director James B. A $205 million scam was carried out by a Miami health care official, who was nabbed and sentenced to jail for 50 years.
While the individual cases were unrelated, law enforcement agencies often coordinate the announcement of health fraud charges and arrests to send a message to fraudsters and the general public alike. He said schemes typically involve billing for drugs that are never dispensed or billing for narcotics and painkillers that are diverted to street sales.
In addition, law enforcement agents executed search warrants at eight locations and seizure warrants of 24 bank accounts related to the alleged schemes.
Announcing this week's arrests, officials said, "the Centers for Medicare & Medicaid Services also suspended a number of providers". They billed Medicare for the devices and received more than $22 million.
United States v. Goldfein, M.D., et al.: Four individuals, a physician and three owners of home health care companies, were charged in a superseding indictment with conspiracy to commit health care and wire fraud, health care fraud, wire fraud and conspiracy to pay or receive health care kickbacks. In one instance, administrators at a Miami mental health facility allegedly billed $64 million in false claims during a six-year period for intensive mental health treatment and paid kickbacks to patient recruiters and operators of assistant living facilities that referred Medicare beneficiaries.
The owner of Mobile Doctors and another physician employee were indicted in the Northern District of Illinois in 2013 for their roles in the same scheme.
Dr. Mohamad Bazzi, 42, of Dearborn was charged in a separate in indictment for an alleged health care fraud scheme totaling over $24 million with Dr. Laran Lerner of Northville.
The government alleges Qadir paid patient recruiter Johnny Younan to bring him patients, for whom he would bill medically unnecessary tests and visits. Allowing all Americans to join Medicare is the best way to control future health care costs while also meeting the needs of the baby boomer and other Americans. Combining all the cases, allegedly fraudulent billings totaled some $712 million. Medicare paid the defendant over $1 million for these purported services.
Many of these cases involved patients being in on the scams by receiving kickback of some sort. This is the largest criminal health care fraud takedown in the history of the Department of Justice. It has charged 2,300 people for scams worth $7 billion.