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Medicare fraud crackdown leads to charges against 107

Published: Thursday, May 3, 2012 10:15 a.m. CST

WASHINGTON (MCT) — Doctors, nurses and social workers from across the country, 107 in all, were charged in what federal officials in Washington called a “nationwide takedown” of medical professionals accused of fraudulently billing Medicare nearly half a billion dollars.

The amount of bogus Medicare claims, about $452 million, was the highest in a single raid in the history of a federal strike force combating rising fraud in the medical industry, according to the Justice Department. Arrests were made in seven major cities.

The Obama administration said it was toughening its attack on those who file bills for ambulance rides never taken and medical procedures never provided.

In addition, officials in the Health and Human Services Department suspended or took other administrative actions against 52 medical providers after analyzing billing requests and finding additional “credible allegations of fraud.”

Assistant Attorney General Lanny Breuer, head of the Justice Department’s criminal division, said the arrests, fourth in a series of Medicare fraud takedowns over the last two years, served as another warning to future scammers.

“Medicare is an attractive target for criminals,” Breuer said, even as prosecution and jail time is risked with every false claim.

“If you don’t believe it,” he said, “ask Lawrence Duran, the former owner of a mental health care company in Miami who was sentenced last year to 50 years in prison. Or his two co-owners, each of whom was sentenced to 35 years.”

Of the 107 defendants in the latest crackdown, 87 were arrested Wednesday. Federal agents were either still looking for the others or expecting them to surrender voluntarily.

The cities involved were Miami; Tampa, Fla.; Houston; Baton Rouge, La.; Los Angeles; Detroit; and Chicago.

In the Los Angeles area, eight people, including two doctors, were charged with fraudulently billing about $20 million for services never provided.

Bolademi Adetola, owner of health care equipment provider Latay Medical Services in Gardena, Calif., was charged with billing Medicare for power wheelchairs that were never purchased. Greatcare Home Health in Los Angeles allegedly paid kickbacks to recruiters to find “patients” who were perfectly fine, and then have doctors knowingly write phony prescriptions for them.

Dr. Augustus Ohemeng and Dr. George Tarryk, who treated patients at the Pacific Clinic in Long Beach, Calif., were among four individuals who allegedly billed falsely for feeding tubes for patients who did not need them.

None of the defendants or their lawyers could be reached for comment.

The Obama administration has stepped up efforts to combat fraud in the Medicare program, which provides health coverage to about 50 million elderly and disabled Americans.

Last year the federal government charged 1,430 people with health care fraud, up from 797 in 2008, according to the Health and Human Services Department. The agency also reported revoking the eligibility of more than 60,000 Medicare and Medicaid providers and suppliers and recovering $4.1 billion in fraudulent claims.

Although there is broad agreement that fraud is widespread in Medicare and Medicaid, estimates of the scope of the program vary from $20 billion a year to $100 billion. Total spending on Medicare and Medicaid is expected to reach about $1 trillion this year.

Louis Saccoccio, chief executive of the National Health Care Anti-Fraud Association, said the latest round of arrests was encouraging and reflected the intensified efforts by the government to combat fraud, especially since 2009.

He said he was most pleased to see that Health and Human Services had stopped payments to 52 providers by using new tools to analyze data and detect potentially fraudulent charges.

The system, which was set up by the health care law President Barack Obama signed two years ago, relies on a computer program to identify patterns of potentially fraudulent charges by providers. “That really has the promise to be a game-changer,” he said. “In the future, what you will see is the real impact is going to come from preventing fraud.”

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(Noam N. Levey of the Tribune Washington Bureau contributed to this report.)

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