Calif. Providers Charged in Nationwide Medicare Fraud Crackdown

On Wednesday, federal prosecutors indicted 107 medical professionals across the U.S. for Medicare fraud, some of whom operate in Southern California, Payers & Providers reports.

The indicted clinic operators, durable medical equipment business owners and physicians are accused of collectively defrauding Medicare of more than $452 million (Payers & Providers, 5/3).

That figure is the highest on record for a single raid by a federal strike force that seeks to combat fraud in the medical industry, according to the U.S. Department of Justice (Serrano, Los Angeles Times, 5/2).

Southern California Indictments

Eight individuals in the Los Angeles area are facing charges. According to Payers & Providers, medical professionals indicted in Southern California are accused of defrauding Medicare of more than $20 million.

Allegations against individuals in the Los Angeles area include:

• Accepting kickbacks for patient referrals;
• Conspiring with a clinic manager and owners of two durable medical equipment companies to prescribe about 400 unnecessary enteral feeding regimens for Medicare beneficiaries;
• Improperly billing for home health care services; and
• Submitting false claims for wheelchairs.

Implications

Lanny Breuer -- assistant U.S. attorney general -- said the indictments "remind us that Medicare is an attractive target for criminals." He added, "But it should also remind those criminals that they risk prosecution and prison time every time they submit a false claim" (Payers & Providers, 5/3).