Assistant Attorney General Lanny A. Breuer Speaks at the Health Care Fraud Takedown Press Conference

Washington, D.C. ~ Thursday, October 4, 2012

Thank you, Secretary Sebelius.   Today, we are announcing charges against 91 defendants in seven Medicare Fraud Strike Force cities across the country.    

 

From Brooklyn, to Miami, to Los Angeles, these defendants allegedly submitted approximately $430 million in fraudulent claims to the Medicare program.   This represents one of the largest Medicare fraud takedowns in Department history, as measured by the amount of alleged fraudulent billings.

 

Today’s defendants include the owners and operators of two different hospitals, one in Miami and one in Houston; 16 medical professionals, including seven physicians, chiropractors, nurses, a psychologist, and a physical therapist.

 

We have made it one of our missions at the Department of Justice to hold accountable those who abuse the Medicare program for personal profit.   And there are Medicare fraudsters in prisons across the country – some who will be there for decades – who can attest to our determination and our effectiveness.  

 

Today’s actions allege multiple, brazen schemes.   In Houston, for example, seven defendants are charged with running a hospital that submitted approximately $158 million in fraudulent claims to Medicare for partial hospitalization program, or PHP, services, which are designed to treat those with severe mental illness.

 

These defendants allegedly bribed Medicare beneficiaries with cigarettes, food and coupons redeemable for items at the hospital’s “country stores,” to entice them to attend the hospital’s PHPs.   But, instead of giving these beneficiaries real medical care, the hospital owners and operators allegedly plunked them in front of the television, and billed Medicare on their behalf, for millions of dollars in expensive mental health treatment.

 

In one of our Miami cases, the owners and operators of a psychiatric hospital are charged with paying cash kickbacks to owners and operators of assisted living facilities and halfway houses to obtain patients, and then billing Medicare for over $67 million in mental health services that were unnecessary or never even provided.   The owners and operators even allegedly sought to have the government reimburse them for the kickbacks, by disguising them as legitimate expenses on cost reports submitted to Medicare.

 

In addition to charging today’s defendants with crimes, we are also restraining their assets.   In another Miami case, for example, we are restraining 40 bank accounts, and 16 residences valued at approximately $4.6 million, that belong to the owners and operators of a home health agency charged with defrauding Medicare to the tune of approximately $74 million.

 

The Criminal Division will continue – together with our partners in the U.S. Attorneys’ offices, the FBI, the Department of Health and Human Services and our many state and local law enforcement colleagues – to fight Medicare fraud across the country, in the smart and effective way we have been doing.  

 

Thank you.   I would now like to turn it over to my colleague from the FBI, Kevin Perkins.