Medicare fraud

Last updated

In the United States, Medicare fraud is the claiming of Medicare health care reimbursement to which the claimant is not entitled. There are many different types of Medicare fraud, all of which have the same goal: to collect money from the Medicare program illegitimately. [1]

Contents

The total amount of Medicare fraud is difficult to track, because not all fraud is detected and not all suspicious claims turn out to be fraudulent. According to the Office of Management and Budget, Medicare "improper payments" were $47.9 billion in 2010, but some of these payments later turned out to be valid. [2] The Congressional Budget Office estimates that total Medicare spending was $528 billion in 2010. [3]

Types

Medicare fraud is typically seen in the following ways:

  1. Phantom billing: The medical provider bills Medicare for unnecessary procedures, or procedures that are never performed; for unnecessary medical tests or tests never performed; for unnecessary equipment; or equipment that is billed as new but is, in fact, used. [4]
  2. Patient billing: A patient who is in on the scam provides his or her Medicare number in exchange for kickbacks. The provider bills Medicare for any reason and the patient is told to admit that he or she indeed received the medical treatment.
  3. Upcoding scheme and unbundling: Inflating bills by using a billing code that indicates the patient needs expensive procedures. [5] [6]

A 2011 crackdown on fraud charged "111 defendants in nine cities, including doctors, nurses, health care company owners and executives" of fraud schemes involving "various medical treatments and services such as home health care, physical and occupational therapy, nerve conduction tests and durable medical equipment." [7]

The Affordable Care Act of 2009 provides an additional $350 million to pursue physicians who are involved in both intentional/unintentional Medicare fraud through inappropriate billing. Strategies for prevention and apprehension include increased scrutiny of billing patterns, and the use of data analytics. The healthcare reform law also provides for stricter penalties; for instance, requiring physicians to return any overpayments to CMS within 60 days time. [8]

As of 2012, regulatory requirements tightened [9] and law enforcement has stepped up. [10] [11] [12]

However, in 2018, a CMS rule intended to limit upcoding was vacated by a judge; [13] it was later appealed in 2019. [14]

Law enforcement and prosecution

Jimmy Carter signs Medicare-Medicaid Anti-Fraud and Abuse Amendments into law Jimmy Carter signs Medicare-Medicaid Anti-Fraud and Abuse Amendments into law. - NARA - 176639.tif
Jimmy Carter signs Medicare-Medicaid Anti-Fraud and Abuse Amendments into law

The Office of Inspector General for the U.S. Department of Health and Human Services, as mandated by Public Law 95-452 (as amended), is established to protect the integrity of Department of Health and Human Services (HHS) programs, to include Medicare and Medicaid programs, as well as the health and welfare of the beneficiaries of those programs. The Office of Investigations for the HHS, OIG collaboratively works with the Federal Bureau of Investigation in order to combat Medicare Fraud.[ citation needed ]

Defendants convicted of Medicare fraud face stiff penalties according to the Federal Sentencing Guidelines and disbarment from HHS programs. The sentence depends on the amount of the fraud. Defendants can expect to face substantial prison time, deportation (if not a US citizen), fines, and restitution[ citation needed ] or have their sentence commuted. [15]

In 1997, the federal government dedicated $100 million to federal law enforcement to combat Medicare fraud. That money pays over 400 FBI agents who investigate Medicare fraud claims. In 2007, the U.S. Department of Health and Human Services, Office of Inspector General, U.S. Attorney's Office, and the U.S. Department of Justice created the Medicare Fraud Strike Force in Miami, Florida. [16] This group of anti-fraud agents has been duplicated in other cities where Medicare fraud is widespread. In Miami alone, over two dozen agents from various federal agencies investigate solely Medicare fraud. In May 2009, Attorney General Holder and HHS Secretary Sebelius Announce New Interagency Health Care Fraud Prevention and Enforcement Action Team (HEAT) to combat Medicare fraud. [17] FBI Director Robert Mueller stated that the FBI and HHS OIG has over 2,400 open health care fraud investigations. [18]

On January 28, 2010, the first "National Summit on Health Care Fraud" was held to bring together leaders from the public and private sectors to identify and discuss innovative ways to eliminate fraud, waste and abuse in the U.S. health care system. [19] The summit was part of the Obama Administration's effort to fight health care fraud.

From January 2009 to June 2012, the Justice Department used the False Claims Act to recover more than $7.7 billion in cases involving fraud against federal health care programs. [20]

Reporting by whistleblowers

The DOJ Medicare fraud enforcement efforts rely heavily on healthcare professionals coming forward with information about Medicare fraud. Federal law allows individuals reporting Medicare fraud to receive full protection from retaliation from their employer and collect up to 30% of the fines that the government collects as a result of the whistleblower's information. [21] According to US Department of Justice figures, whistleblower activities contributed to over $13 billion in total civil settlements in over 3,660 cases stemming from Medicare fraud in the 20-year period from 1987 to 2007. [22]

International Medical Centers HMO and Jeb Bush

In 1985, Miguel G. Recarey Jr., CEO of International Medical Centers (IMC), a Florida-based health maintenance organization (HMO) was charged with bribing a Medicare officer, bribing a potential federal grand jury witness, and illegal wiretapping in U.S. District Court in Florida. He failed to appear for a hearing. Recarey received US$781 million in Medicare payments for 197 000 enrollees but did not pay doctors and hospitals for their care. [23] Recarey had "employed" Jeb Bush as a real estate consultant and paid him a US$75,000 fee for finding IMC a new location, although the move never took place. Bush lobbied the Reagan administration successfully on behalf of Recarey and IMC to waive a rule of maximum 50% Medicare enrollee proportion. [24] [25] As of 2015, Recarey was a fugitive living in Spain. [25] The IMC fraud was then one of the largest in Medicare history. [26]

Columbia/HCA fraud case, 1996-2004

The Columbia/HCA fraud case is one of the largest examples of Medicare fraud in U.S. history. Numerous New York Times stories, beginning in 1996, began scrutinizing Columbia/HCA's business and Medicare billing practices. These culminated in the company being raided by Federal agents searching for documents and eventually the ousting of the corporation's CEO, Rick Scott, by the board of directors. [27] Among the crimes uncovered were doctors being offered financial incentives to bring in patients, falsifying diagnostic codes to increase reimbursements from Medicare and other government programs, and billing the government for unnecessary lab tests, [28] though Scott personally was never charged with any wrongdoing. HCA wound up pleading guilty to more than a dozen criminal and civil charges and paying fines totaling $1.7 billion. In 1999, Columbia/HCA changed its name back to HCA, Inc.

In 2001, Hospital Corporation of America (HCA) reached a plea agreement with the U.S. government that avoided criminal charges against the company and included $95 million in fines. [29] In late 2002, HCA agreed to pay the U.S. government $631 million, plus interest, and pay $17.5 million to state Medicaid agencies, in addition to $250 million paid up to that point to resolve outstanding Medicare expense claims. [30] In all, civil lawsuits cost HCA more than $1.7 billion to settle, including more than $500 million paid in 2003 to two whistleblowers. [29]

Omnicare fraud, 1999-2010

From 1999 to 2004, Omnicare a major supplier of drugs to nursing homes, solicited and received kickbacks from Johnson & Johnson for recommending that physicians prescribe Risperdal, a Johnson & Johnson antipsychotic drug to nursing home patients. During this time Omnicare increased its annual drug purchases from $100 million to more than $280 million. [31]

Starting in 2006, healthcare entrepreneur Adam B. Resnick sued Omnicare, under the False Claims Act, as well as the parties to the company's illegal kickback schemes. Omnicare allegedly paid kickbacks to nursing home operators in order to secure business, which constitutes Medicare fraud and Medicaid fraud. Omnicare allegedly had paid $50 million to the owners of the Mariner Health Care Inc. and SavaSeniorCare Administrative Services LLC nursing home chains in exchange for the right to continue providing pharmacy services to the nursing homes. [32]

In November 2009, Omnicare paid $98 million to the federal government to settle five qui tam lawsuits brought under the False Claims Act and government charges that the company had paid or solicited a variety of kickbacks. [33] The company admitted no wrongdoing. [31]

In 2010, Omnicare settled Resnick's False Claims Act suit that had been taken up by the U.S. Department of Justice by paying $19.8 million to the federal government, while Mariner and SavaSeniorCare settled for $14 million. [34] [35]

Michigan Hematology-Oncology fraud

In 2013, Dr. Farid T. Fata was arrested on charges of providing chemotherapy treatments to patients who did not have cancer. Over a period of at least six years, Fata submitted US$34 million in fraudulent charges to private health practices and Medicare. At the time of his arrest, Fata owned Michigan Hematology-Oncology, one of Michigan's largest cancer practices. In September 2014, Fata pled guilty to sixteen federal charges: thirteen counts of healthcare fraud, two counts of money laundering, and one count of conspiring to pay and receive kickbacks and cash payments for referring patients to a particular hospice and home health care company. [36] In addition to chemotherapy malpractice, the court found Fata guilty of mistreating patients with inappropriate octreotide, potent antiemetics, and parenteral vitamins.

Fata's fraud scheme was discovered after one of his patients suffered an injury unrelated to his treatment. After beginning a lifelong chemotherapy treatment prescribed by Fata, patient Monica Flagg broke her leg and was seen by another physician at his practice, Dr. Soe Maunglay. Maunglay realized that Flagg did not have cancer and advised her to switch doctors immediately. Although he was already due to leave Fata's practice over ethical concerns, Maunglay brought his concerns to the clinic's business manager, George Karadsheh. Karadsheh filed a successful False Claims Act suit against Fata, leading to his arrest. [37] Barbara McQuade, the U.S. Attorney for the Eastern District of Michigan at the time, called the case "the most egregious case of fraud that [she had] ever seen in [her] life." [38]

2010 Medicare Fraud Strike Task Force Charges

2011 Medicare Fraud Strike Task Force Charges

In September 2011, a nationwide takedown by Medicare Fraud Strike Force operations in eight cities resulted in charges against 91 defendants for their alleged participation in Medicare fraud schemes involving approximately $295 million in false billing. [46]

2012 Medicare Fraud Strike Task Force Charges

In 2012, Medicare Fraud Strike Force operations in Detroit resulted in convictions [47] against 2 defendants for their participation in Medicare fraud schemes involving approximately $1.9 million in false billing.

Victor Jayasundera, a physical therapist, pleaded guilty on January 18, 2012, and was sentenced in the Eastern District of Michigan. In addition to his 30-month prison term, he was sentenced to three years of supervised release and was ordered to pay $855,484 in restitution, joint and several with his co-defendants.

Fatima Hassan, co-owned a company known as Jos Campau Physical Therapy with Javasundera, pleaded guilty on August 25, 2011, for her role in the Medicare fraud schemes and on May 17, 2012, was sentenced to 48 months in prison.

2013 Medicare Fraud Strike Task Force Charges

In May 2013, Federal officials charged 89 people including doctors, nurses, and other medical professionals in eight U.S. cities with Medicare fraud schemes that the government said totaled over $223 million in false billings. [48] The bust took more than 400 law enforcement officers including FBI agents in Miami, Detroit, Los Angeles, New York and other cities to make the arrests. [49]

2015 Medicare Fraud Strike Task Force Charges

In June 2015, Federal officials charged 243 people including 46 doctors, nurses, and other medical professionals with Medicare fraud schemes. The government said the fraudulent schemes netted approximately $712 million in false billings in what is the largest crackdown undertaken by the Medicare Fraud Strike Force. The defendants were charged in the Southern District of Florida, Eastern District of Michigan, Eastern District of New York, Southern District of Texas, Central District of California, Eastern District of Louisiana, Northern District of Texas, Northern District of Illinois and the Middle District of Florida. [50]

2019 Medicare Fraud Strike Task Force Charges

In April 2019, Federal officials charged Philip Esformes, 48 years old, of paying and receiving kickbacks and bribes in the then largest Medicare fraud case in U.S. history. The fraud took place between 2007 until 2016 and involved about $1.3 billion worth of fraudulent claims. Esformes was described as "a man driven by almost unbounded greed,". [15]  Esformes owned more than 20 assisted living facilities and skilled nursing homes. [51] Former Hospital Executive Odette Barcha, 50, was Esformes’ accomplice along with Arnaldo Carmouze, 57, a physical assistant in the Palmetto Bay, Florida area. These three constructed a team of corrupt physicians, hospitals, and private practices in South Florida. The scheme worked as follows: bribes and kickbacks where paid to physicians, hospitals, and practices to refer patients to the facilities owned and controlled by Esformes. The assisted living and skilled nursing facilities would admit the patients and bill Medicare and Medicaid for unnecessary, fabricated and sometimes harmful procedures. Some of the charges to Medicare and Medicaid included prescription narcotics prescribed to patients addicted to opioids to entice the patients to stay at the facility in order for the bill to increase. Another technique was to move patients in and out of facilities when the patients had reached the maximum number of days allowed by Medicare and Medicaid. This was accomplished by using one of the corrupt physicians to see the patients and coordinate for readmission in the same or a different facility owned by Esformes. Per Medicare and Medicaid guidelines, a patient is allowed 100 days at a skilled nursing facility after a hospital stay. The patient is given an additional 100 days if the he/she spends 6 days outside of a facility or is readmitted to a hospital for 3 additional days. The facilities not only fabricated medical documents to show treatment was done to a patient, they also hiked up the prices to equipment and medications that were never consumed or used. Barcha as the Director of the Outreach program expanded the group of corrupt physicians and practices. She would advise the community physicians and hospitals to refer patients to the facilities owned by Esformes in exchange for monetary gifts. The law against kickbacks is called the Anti-Kickback Statute or Stark Law, which makes it illegal for medical providers to refer patients to a facility owned by the physician or a family member for services billable to Medicare and Medicaid. It also prohibits providers to receive bribes for patient referrals. Carmouze prescribed unnecessary prescription drugs to patients who may or may not have needed the medications. He also facilitated community physicians to visit the patient in the assisted living facilities owned by Esformes in order for the physician to bill Medicare and Medicaid, for which Esformes received kickbacks. Carmouze also assisted in falsifying medical documentation to represent proof of medical necessity for many of the medications, procedures, visits, and equipment charged to the government. Esformes has been detained since 2016. In 2019, he was convicted to 20 years in prison. [52]

On December 22, 2020, President Donald Trump commuted his sentence, upon suggestion by his son in law Jared Kushner and the Aleph Institute. [15]

See also

Related Research Articles

<span class="mw-page-title-main">Medicaid</span> United States social health care program for families and individuals with limited resources

In the United States, Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a significant portion of their funding.

<span class="mw-page-title-main">Centers for Medicare & Medicaid Services</span> United States federal agency

The Centers for Medicare & Medicaid Services (CMS), is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards. In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in long-term care facilities through its survey and certification process, clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments, and oversight of HealthCare.gov. CMS was previously known as the Health Care Financing Administration (HCFA) until 2001.

<span class="mw-page-title-main">HCA Healthcare</span> American healthcare facilities company

HCA Healthcare is an American for-profit operator of health care facilities that was founded in 1968. It is based in Nashville, Tennessee, and, as of May 2020, owned and operated 186 hospitals and approximately 2,000 sites of care, including surgery centers, freestanding emergency rooms, urgent care centers and physician clinics in 21 states and the United Kingdom. As of 2023, HCA Healthcare is ranked #66 on the Fortune 500 rankings of the largest United States corporations by total revenue.

<span class="mw-page-title-main">Tenet Healthcare</span> American healthcare company

Tenet Healthcare Corporation is a for-profit multinational healthcare services company based in Dallas, Texas, United States. Through its brands, subsidiaries, joint ventures, and partnerships, including United Surgical Partners International (USPI), the company operates 65 hospitals and over 450 healthcare facilities. Tenet also operates Conifer Health Solutions, which provides healthcare support services to health systems and other clients.

<span class="mw-page-title-main">Omnicare</span> American health care company

Omnicare is an American company working in the health-care industry. It was established in April 1981 as a spinoff of healthcare businesses from Chemed and W. R. Grace and Company. It is currently a pharmacy specializing in nursing homes. In 2015, Omnicare was acquired by CVS Health.

Prime Healthcare Services is a United States privately held healthcare company. It was established in 2001, by chairman and CEO Prem Reddy, MD, and operates 45 hospitals in 14 states. It is affiliated with the nonprofit Prime Healthcare Foundation.

Healthcare reform in the United States has a long history. Reforms have often been proposed but have rarely been accomplished. In 2010, landmark reform was passed through two federal statutes: the Patient Protection and Affordable Care Act (PPACA), signed March 23, 2010, and the Health Care and Education Reconciliation Act of 2010, which amended the PPACA and became law on March 30, 2010.

There were a number of different health care reforms proposed during the Obama administration. Key reforms address cost and coverage and include obesity, prevention and treatment of chronic conditions, defensive medicine or tort reform, incentives that reward more care instead of better care, redundant payment systems, tax policy, rationing, a shortage of doctors and nurses, intervention vs. hospice, fraud, and use of imaging technology, among others.

Adam B. Resnick is an American health care entrepreneur, public speaker, author, and professional whistleblower.

Shasta Regional Medical Center, formerly known as Redding Medical Center and Memorial Hospital, is a general acute care hospital that is located in Redding, California. It opened in 1945 and currently has 226 beds with a basic emergency department.

A case of Medicaid fraud was carried out in 2010 by an Armenian-American organized crime group called the Mirzoyan–Terdjanian organization. The scam involved a crime syndicate which created 118 fake clinics in 25 states and used stolen medical license numbers of real doctors and matched them to legitimate Medicare patients whose names and billing information were also stolen. The group submitted more than $163 million in claims and received $35 million of that before they were caught. Prosecutors charged 73 individuals in several states with allegations of racketeering conspiracy, bank fraud, money laundering and identity theft.

Health care fraud includes "snake oil" marketing, health insurance fraud, drug fraud, and medical fraud. Health insurance fraud occurs when a company or an individual defrauds an insurer or government health care program, such as Medicare or equivalent State programs. The manner in which this is done varies, and persons engaging in fraud are always seeking new ways to circumvent the law. Damages from fraud can be recovered by use of the False Claims Act, most commonly under the qui tam provisions which rewards an individual for being a "whistleblower", or relator (law).

Pharmaceutical fraud involves activities that result in false claims to insurers or programs such as Medicare in the United States or equivalent state programs for financial gain to a pharmaceutical company. There are several different schemes used to defraud the health care system which are particular to the pharmaceutical industry. These include: Good Manufacturing Practice (GMP) Violations, Off Label Marketing, Best Price Fraud, CME Fraud, Medicaid Price Reporting, and Manufactured Compound Drugs. Examples of fraud cases include the GlaxoSmithKline $3 billion settlement, Pfizer $2.3 billion settlement, and Merck $650 million settlement. Damages from fraud can be recovered by use of the False Claims Act, most commonly under the qui tam provisions which rewards an individual for being a "whistleblower", or relator (law).

<i>United States v. GlaxoSmithKline</i>

United States v. GlaxoSmithKline was a case before the United States District Court for the Eastern District of Pennsylvania. Robert J. Merena was one of the first who filed claims against SmithKline Beecham Clinical Laboratories on November 12, 1993. The complaints alleged that GlaxoSmithKline, which operated a system of clinical laboratories, adopted myriad complicated procedures for the purpose of defrauding state and federal healthcare programs, in particular Medicare and Medicaid. The U.S. Justice Department publicly praised Robert Merena for his "cooperation and support" in helping the government collect the largest settlement ever involving a whistle-blower lawsuit. The SmithKline settlement is considered to be one of the largest whistleblower assisted recoveries in the history of the United States.

The Health Information Technology for Economic and Clinical Health Act, abbreviated the HITECH Act, was enacted under Title XIII of the American Recovery and Reinvestment Act of 2009. Under the HITECH Act, the United States Department of Health and Human Services resolved to spend $25.9 billion to promote and expand the adoption of health information technology. The Washington Post reported the inclusion of "as much as $36.5 billion in spending to create a nationwide network of electronic health records." At the time it was enacted, it was considered "the most important piece of health care legislation to be passed in the last 20 to 30 years" and the "foundation for health care reform."

Health care finance in the United States discusses how Americans obtain and pay for their healthcare, and why U.S. healthcare costs are the highest in the world based on various measures.

<span class="mw-page-title-main">Medicare Fraud Strike Force</span>

The Medicare Fraud Strike Force is a multi-agency team of United States federal, state, and local investigators who combat Medicare fraud through data analysis and increased community policing. Launched in 2007, the Strike Force is coordinated by the United States Department of Justice and the Department of Health and Human Services. It combines the data-analysis capabilities of the Centers for Medicare and Medicaid Services, the investigative resources of the FBI, and the prosecutorial resources of the Department of Justice and the U.S. Attorneys' Offices.

IPC Healthcare, previously known as IPC The Hospitalist Company, was a publicly traded corporation which operates a national physician group practice focused on the delivery of hospital medicine and related facility-based services. IPC providers manage the care of patients in coordination with primary care physicians and specialists in over 1,900 facilities in 28 states across the U.S. The company name is derived from an earlier company called In-Patient Consultants Management, Inc. and the NASDAQ ticker name was changed to IPCM in 2008. The company changed its name to IPC Healthcare in January 2015. The company was acquired by TeamHealth in 2015 for $1.6 billion.

Farid T. Fata is a Lebanese-born former hematologist/oncologist and the mastermind of one of the largest health care frauds in U.S. history. Fata was the owner of Michigan Hematology-Oncology (MHO), one of the largest cancer practices in Michigan. He was arrested in 2013 on charges of prescribing chemotherapy to patients who were healthy or whose condition did not warrant chemotherapy, then submitting $34 million in fraudulent charges to Medicare and private health insurance companies over a period of at least six years.

The Anti-Kickback Statute (AKS) is an American federal law prohibiting financial payments or incentives for referring patients or generating federal healthcare business. The law, codified at 42 U.S. Code § 1320a–7b(b), imposes criminal and, particularly in association with the federal False Claims Act, civil liability on those that knowingly and willfully offer, solicit, receive, or pay any form of remuneration in exchange for the referral of services or products covered by any federal healthcare program, subject to certain narrow exceptions. In other words, the statute covers both those that provide kickbacks and those that receive kickbacks. The statute is among the most important healthcare fraud and abuse laws in the United States. Violation of the AKS is a felony.

References

  1. ↑ "Medicare Fraud and Fraud in Other Government Healthcare Programs" . Retrieved 2017-12-05.
  2. ↑ politifact.com (2011-01-04). Retrieved on 2011-01-05.
  3. ↑ "The Budget and Economic Outlook: Fiscal Years 2010 to 2020" (PDF). Congressional Budget Office. 26 January 2010. Retrieved 30 October 2014.
  4. ↑ Steven Greenhouse (July 10, 2009). "Brooklyn Doctor Charged With Workers' Compensation Fraud". The New York Times . Retrieved July 28, 2022.
  5. ↑ "Upcoding Fraud » Constantine Cannon" . Retrieved December 5, 2017.
  6. ↑ "Risk Adjustment Fraud » Constantine Cannon" . Retrieved December 5, 2017.
  7. ↑ "hhs.gov". hhs.gov. May 7, 2011. Retrieved January 2, 2012.
  8. ↑ Westgate, Aubrey (May 2012), Medicare Fraud and Abuse and Your Practice, Physicians Practice
  9. ↑ "cms.gov" (PDF). Retrieved 2012-01-02.
  10. ↑ "oig.hhs.gov" (PDF). Retrieved 2012-01-02.
  11. ↑ Allen, Greg (2010-02-23). "m.npr.org". m.npr.org. Retrieved 2012-01-02.
  12. ↑ "Medicare Fraud Reporting Center - Report Medicare Fraud Here - What is Medicare Fraud?". Medicarefraudcenter.org. Retrieved 2012-01-02.
  13. ↑ "More Medicare Advantage upcoding could follow court ruling". Modern Healthcare. 2018-09-12. Retrieved 2019-05-26.
  14. ↑ "CMS appeals ruling on Medicare Advantage overpayments: 4 things to know". www.beckershospitalreview.com. Becker's Hospital Review . Retrieved 2019-05-26.
  15. 1 2 3 Vogel, Kenneth P.; Lipton, Eric; Drucker, Jesse (2020-12-24). "Behind Trump Clemency, a Case Study in Special Access". The New York Times. ISSN   0362-4331 . Retrieved 2023-09-26.
  16. ↑ Feds Fight Rampant Medicare Fraud in South Florida. NPR. Retrieved on 2010-11-04.
  17. ↑ Attorney General Holder and HHS Secretary Sebelius Announce New Interagency Health Care Fraud Prevention and Enforcement Action Team. Hhs.gov (2010-10-18). Retrieved on 2010-11-04.
  18. ↑ Johnson, Carrie (June 25, 2009). "53 in Detroit and Miami Indicted in Medicare Fraud Sting". The Washington Post. Retrieved May 12, 2010.
  19. ↑ Health & Human Services Secretary Kathleen Sebelius, Attorney General Eric Holder Convene National Summit on Health Care Fraud, Unveil Historic Commitment to Fighting Fraud in President’s FY 2011 Budget. Hhs.gov (2010-10-18). Retrieved on 2010-11-04.
  20. ↑ "New Jersey Hospital Pays U.S. $8,999,999 to Settle False Claims Act Allegations". US Department of Justice. 2012-06-21. Retrieved 2012-06-26.
  21. ↑ "Medicare Fraud Center - Report Medicare Fraud Here".
  22. ↑ "Who can become a Medicare fraud whistleblower?".
  23. ↑ "Alleged misconduct by international medical centers: statement of David C Williams, Director Office of Special Investigations" (PDF). GAO. 1987-12-15.
  24. ↑ Campbell, Duncan "The Bush dynasty and the Cuban criminals." Archived August 26, 2013, at the Wayback Machine The Guardian (December 2, 2002). Retrieved October 8, 2023.
  25. 1 2 Washington Post (2015-03-15). "Jeb Bush's tie to fugitive Miguel Recarey goes against business-savvy image he promotes". Tampa Bay Times. Retrieved 2023-09-26.
  26. ↑ Ryan Grim (2015-02-20). "When Dad Was VP, Jeb Bush Lobbied The Administration For A Medicare Fraudster". Huffington Post. Retrieved 2023-09-26.
  27. ↑ Moewe, M.C. (April 17, 2006). "Jacksonville Business Journal Friday, April 14, 2006". Jacksonville.bizjournals.com. Retrieved 2012-01-02.
  28. ↑ Bringing HCA Back to Life After years of scandal. Fortune Magazine Feb 2004
  29. 1 2 M.C. Moewe (April 14, 2006). "Ex-Columbia chief helps grow Solantic". Jacksonville Business Journal.
  30. ↑ Julie Appleby (December 18, 2002). "HCA to settle more allegations for $631M". USA Today.
  31. 1 2 Hilzenrath, David S. (January 16, 2010). "Justice suit accuses Johnson & Johnson of paying kickbacks". The Washington Post. Retrieved January 17, 2010.
  32. ↑ U.S. Department of Justice (March 4, 2009). "Complaint of the United States in the District Court of Massachusetts CA No. 06-10149 RGS" (PDF).
  33. ↑ Department of Justice (November 3, 2009). "Nation's largest nursing home pharmacy and drug manufacturer to pay $112 million to settle false claims act cases".
  34. ↑ Ameet, Sachdev (February 11, 2010). "Scheme's victims seeking restitution FDIC could get most of payment;". Chicago Tribune. Retrieved 12 September 2013.
  35. ↑ "Prominent New York City Real Estate Investor, Attorney and Atlanta Nursing Home Chains Pay $14 Million to Settle Whistleblower Kickback Case". PR Newswire. Retrieved 12 September 2013.
  36. ↑ Steensma, David P. (January 2016). "The Farid Fata Medicare Fraud Case and Misplaced Incentives in Oncology Care". Journal of Oncology Practice. 12 (1): 51–54. doi:10.1200/JOP.2015.008557. ISSN   1554-7477. PMID   26733620.
  37. ↑ Team, Legal (2022-04-11). "Can a Personal Injury Client Have a Whistleblower Case?". YoumanCaputo. Retrieved 2023-03-07.
  38. ↑ Sweeney, Evan (January 18, 2016). "How a broken leg set off the fraud investigation against Farid Fata | Fierce Healthcare". Fierce Healthcare. Retrieved March 7, 2023.
  39. 1 2 Federal Bureau of Investigation press release, July 16, 2010, Medicare Fraud Strike Force Charges 94 Doctors, Health Care Company Owners, Executives, and Others for More Than $251 Million in Alleged False Billing
  40. 1 2 Miami Herald, Feds charge 94 medicare suspects in Miami other cities, July 17, 2010, Jay Weaver
  41. ↑ Authorities charge 94 suspects for medicare fraud, PBS Newshour, July 16, 2010, accessed July 17, 2010, Lea Winerman
  42. ↑ Hairenik (14 October 2010). "Dozens of Armenians Charged with Largest Medicare Scam Ever". armenianweekly.com.
  43. ↑ "Armenian gangsters charged in $160M Medicare scam". nypost.com. 14 October 2010.
  44. ↑ Ailsa Chang (October 14, 2010). "52 arrested in sweeping Medicare fraud case". National Public Radio . Retrieved October 18, 2010.
  45. ↑ "Feds take down largest-ever Medicare fraud ring". Mass Device. October 14, 2010. Retrieved October 18, 2010.
  46. ↑ "Medicare Fraud Strike Force Charges 91 Dr Barbour of Palm Springs CaIndividuals for Approximately $295 Million in False Billing" (Press release). U.S. Department of Justice. September 7, 2011. Retrieved September 10, 2011.
  47. ↑ "Co-Owner of Detroit-Area Therapy Company Sentenced to 30 Months for Medicare Fraud Scheme". U.S. Department of Justice. 2012-06-07. Retrieved 2012-06-14.
  48. ↑ Recent Medicare Fraud Scams and Busts Hank Pomeranz, Retrieved May 23, 2013.
  49. ↑ U.S. charges 89 people in Medicare fraud schemes U.S. Department of Justice: Retrieved May 14, 2013.
  50. ↑ National Medicare Fraud Takedown Results in Charges Against 243 Individuals for Approximately $712 Million in False Billing U.S. Department of Justice: Retrieved June 23, 2015.
  51. ↑ O'Keeffe, K (July 23, 2016). "Justice department charges three in $1 billion medicare fraud scheme in Florida; prosecutors outline details of its largest-ever single criminal health-care fraud case". Wall Street Journal. ProQuest   1806148256.
  52. ↑ "Fla. healthcare executive found guilty in $1B Medicare fraud case". Modern Healthcare. 2019-04-05. Retrieved 2019-07-31.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.