Last February, 111 people from across the country were charged after investigation by a Medicare fraud strike force. The action was the largest Medicare fraud bust in history. It involved more than 700 law enforcement officials targeting a range of actions they claimed defrauded the Medicare program of more than $225 million.
In South Florida, 32 people, including two doctors, were charged with criminal acts. One of them, a 59-year-old pain doctor in Clearwater was recently found not guilty of six counts of Medicare fraud. After a federal criminal trial lasting roughly one week, the court concluded that she did not willfully or intentionally defraud Medicare in connection with $457,000 worth of claims.
The Florida doctor was accused of submitting claims for services on behalf of another doctor. That doctor was not allowed to submit claims to Medicare due to a prior criminal action. There was no indication of whether the claims themselves would have been paid if performed by a doctor with access to Medicare funds. The not guilty verdict was based on fact that she did not know of the other doctor's criminal background.
While the size and scope of the investigation drew headlines, the individuals charged with Medicare fraud should not be ignored. In this case, an accused medical professional was vindicated after months of pain and worry. For at least one person arrested in this operation, the end result is a not guilty verdict and a return to work.
Source: St. Petersburg Times, "Clearwater pain doctor cleared in Medicare fraud case," Lorri Helfand, 30 July 2011