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Medicare fraud scams shut down across the country

Four people from Baton Rouge, Louisiana, have been apprehended in a nationwide sweep that saw more than 90 people indicted. According to allegations, the 91 defendants participated in a massive Medicare scam and fraud charges have been filed against many of the people that were allegedly involved. The government aggressively prosecutes suspected Medicaid or Medicare fraud cases which means anyone accused in this case would be wise to consult with a criminal defense attorney experienced in federal investigations and charges involving white collar crimes such as these.

Estimates indicate that the scam saw nearly $430 million paid to hospitals and other medical centers for fraudulent claims that were reportedly billed to the federal government. According to the charges, more than $49 million is related to ambulance transportation fraud, more than $100 million is related to mental health care fraud and more than $230 million is related to home health care fraud.

The U.S. Department of Health and Human Services is authorized to stop payments thanks to the Affordable Care Act once an investigation into fraudulent activity has begun, meaning that many of the involved medical centers and professionals are likely to be disallowed from treating Medicare patients. Evidence of fraud was examined by investigators and, because of that, at least 30 health care providers are either facing administrative action or have been suspended.

Reports indicate that arrests have been made in Baton Rouge, Chicago, Dallas, Los Angeles and Miami, to name just a few cities. In Baton Rouge, the four defendants were reportedly involved in $2.4 million worth of fraud that saw durable medical equipment given to patients that did not need it. One of those suspects is a licensed practical nurse.

In Texas, a community mental health center was billed more than $150 million. Seven individuals were reportedly behind this scam, some having served as administrators at the health center. According to the U.S. Justice Department, the hospital billed Medicare for services that never occurred. Instead, authorities allege that patients were playing games and watching television instead of receiving the treatments that were billed for. Some of the patients were supposedly paid kickbacks for participating in the scam-items allegedly given to the patients include food and cigarettes.

Source: Catholic Online, "Doctors, nurses, individuals indicted in massive Medicare fraud," Oct. 5, 2012

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