Government Cracks Down on Medicare Fraud

Government Cracks Down on Medicare Fraud | Pintas & Mullins Law Firm

Medicare fraud is a crime that our Illinois Medicare fraud lawyers take seriously. And so does the U.S. government. A recent Reuters article reveals one of the largest government crackdowns in recent months, that led to Medicare fraud charges against more than 90 people.

The latest raid involved about 91 physicians, nurses, and other medical experts who were accused of various fraud allegations. These charges include writing unnecessary prescriptions for Dallas patients, billing the government for needless ambulance trips in California, and paying patients in kickbacks such as cigarettes and food for taking part in programs that the hospital could later be reimbursed for.

According to a statement by the Health and Human Services (HHS) secretary, the raid should deter people who are considering or already taking part in Medicare and Medicaid fraud. Medicare and Medicaid are important government programs and swindling government funds for personal gain is a serious crime. Fortunately, the government has a new tool in its arsenal against Medicare fraud, with new software that checks payment requests for suspicious irregularities.

The head of the Justice Department’s Criminal Division said that the government expects to recover only a portion of more than $430 million in lost funds. Some of the other allegations against the defendants involved money laundering and identity theft.

The importance of the Medicare program cannot be underscored. The critical government program that provides health care for the elderly is worth approximately $590 billion, and meets the needs of close to 50 million people. However, it is also an attractive pot of money for those looking to engage in illegal fraud, abuse and waste.

Physician Assistant Gets 6 Years for Medicare Fraud

Similarly, the Park Labrea News/Beverly Press reported that a Los Angeles physician assistant was sentenced to six years in prison for taking part in an $18.9 million Medicare deception scheme. The accused engaged in identity theft of physicians in order to write prescriptions that were not medically required, diagnostic tests, and costly durable medical equipment. Additionally, the 50-year-old accused was ordered to serve three years of supervised release and make a combined payment of $24,935 with his co-defendants.

Evidence revealed that the physician was employed at fraudulent medical clinics that functioned as prescription mills. He traded in fake orders and prescriptions for medically unnecessary diagnostic tests and medical equipment in an attempt to swindle Medicare. The accused ordered the tests and penned the prescriptions on behalf of physicians who did not give him permission to do so. 

Qui Tam Lawsuits and the False Claims Act

If you come across a situation which you suspect to be Medicare/Medicaid fraud or any other kind of fraud against the federal government, you can file a Qui Tam lawsuit with the assistance of a competent whistleblower lawyer.

A qui tam lawsuit, or whistleblower lawsuit, is brought by a private person against someone who violated a government statute. In this kind of action, the person who files the lawsuit can recover a portion of the statutorily imposed penalty for exposing the wrongdoing. This may involve significant compensation.