Video: Every Case Tells a Story| Webinar: ACR/CHEST ILD Guidelines in Practice

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

  • Conditions
    • Axial Spondyloarthritis
    • Gout and Crystalline Arthritis
    • Myositis
    • Osteoarthritis and Bone Disorders
    • Pain Syndromes
    • Pediatric Conditions
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Sjögren’s Disease
    • Systemic Lupus Erythematosus
    • Systemic Sclerosis
    • Vasculitis
    • Other Rheumatic Conditions
  • FocusRheum
    • ANCA-Associated Vasculitis
    • Axial Spondyloarthritis
    • Gout
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Systemic Lupus Erythematosus
  • Guidance
    • Clinical Criteria/Guidelines
    • Ethics
    • Legal Updates
    • Legislation & Advocacy
    • Meeting Reports
      • ACR Convergence
      • Other ACR meetings
      • EULAR/Other
    • Research Rheum
  • Drug Updates
    • Analgesics
    • Biologics/DMARDs
  • Practice Support
    • Billing/Coding
    • EMRs
    • Facility
    • Insurance
    • QA/QI
    • Technology
    • Workforce
  • Opinion
    • Patient Perspective
    • Profiles
    • Rheuminations
      • Video
    • Speak Out Rheum
  • Career
    • ACR ExamRheum
    • Awards
    • Career Development
  • ACR
    • ACR Home
    • ACR Convergence
    • ACR Guidelines
    • Journals
      • ACR Open Rheumatology
      • Arthritis & Rheumatology
      • Arthritis Care & Research
    • From the College
    • Events/CME
    • President’s Perspective
  • Search

Authorities Arrest 243 People in $712 Million Medicare Fraud

Megan Cassella  |  June 22, 2015

(Reuters)—The U.S. Department of Justice said on Thursday that 243 people have been arrested across the country, charged with submitting fake billing for Medicare, a government healthcare program, that totaled $712 million.

Attorney General Loretta Lynch described the arrests as the largest criminal healthcare fraud takedown in the history of the Justice Department.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Those arrested included 46 doctors, nurses and other licensed medical professionals. The charges are based on a variety of alleged fraud schemes, the government said, including submitting claims to Medicare and Medicaid, the healthcare program for low-income individuals, for treatments that were medically unnecessary and often never provided.

The nationwide sweep, led by the Medicare Fraud Strike Force and the U.S. Centers for Medicare and Medicaid Services, involved about 900 law enforcement officials. It’s the largest both in terms of the number of those charged and the amount of money lost.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

Many of the arrests were in Florida, long an epicenter of Medicare fraud. In Miami, 73 defendants were charged with offenses involving approximately $263 million in false billings.

One mental health facility there billed close to $64 million for psychotherapy sessions that were nothing more than moving patients to different locations, Lynch said in a press conference.

Other cities involved include Houston, Dallas and McAllen, Texas; Los Angeles; Detroit; Tampa; Brooklyn, New York; and New Orleans.

One case in Michigan involved a doctor who prescribed unnecessary narcotics in exchange for patients’ identification information, which was used to generate false billings. Patients then became deeply addicted to the prescription narcotics and were bound to the scheme as long as they wanted to keep their access to the drugs.

“In the days ahead, the Department of Justice will continue our focus on preventing wrongdoing and prosecuting those whose criminal activity drives up medical costs and jeopardizes a system that our citizens trust with their lives,” Lynch said.

Since 2007, as part of increased efforts to tackle Medicare fraud, federal authorities have charged nearly 2,100 people with falsely billing the Medicare program more than $6.5 billion, according to the Justice Dept. Thursday’s arrests bring that total to over 2,300 people who have billed over $7 billion.

Share: 

Filed under:EthicsLegal Updates

Related Articles

    Five Most Important Fraud, Abuse Laws Applicable to Physicians

    June 1, 2014

    Know what’s included in the federal False Claims Act, Anti-Kickback Statute and other regulations and guidelines to prevent Medicare abuse

    Rheuminations: Fraud Casts a Pall on Medical Research

    July 1, 2013

    The history, causes, and effects of scientific misconduct and strategies to reduce fraud and plagiarism in clinical medicine

    Fraud and Abuse: What’s the Difference?

    November 1, 2007

    Each year, fraud and abuse cost the Medicare and Medicaid programs billions of dollars. What is the difference between fraud and abuse? The Centers for Medicare & Medicaid Services define fraud and abuse as two different offenses…

    Different Payer Audits Require Different Preparation & Response

    June 21, 2018

    For a provider of healthcare services, payer audits are always a possibility. Both government and private payers consistently monitor providers to prevent fraud, overpayment, and improper billing or coding procedures. Audits can be nerve-racking and intimidating, even if a provider is billing correctly. Improper billing can lead to civil and criminal sanctions. To alleviate some…

  • About Us
  • Meet the Editors
  • Issue Archives
  • Contribute
  • Advertise
  • Contact Us
  • Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1931-3268 (print). ISSN 1931-3209 (online).
  • DEI Statement
  • Privacy Policy
  • Terms of Use
  • Cookie Preferences