As another indicator of the government’s aggressive focus on Medicare and Medicaid fraud, federal investigators seized 92 people across the country. The defendants, including 34 people from Miami, will face federal fraud charges. Overall, the government says that these cases represent $432 million in fraud.
These arrests are another result of a joint task force known as Operation HEAT. Operation HEAT aims to investigate and prosecute healthcare fraud throughout the country. The project focuses on nine “strike force” cities: Miami, Baton Rouge, Brooklyn, Chicago, Dallas, Detroit, Los Angeles, Houston, and Tampa.
Although only 34 defendants are from the Miami area, prosecutors say almost half of the $432 million fraudulent conduct occurred there. Federal agents raided several businesses, including a home health care company and a psychiatric facility.
Many Medicare and Medicaid fraud prosecutions often involve billing procedures. If healthcare providers inadvertently prescribe or bill for unnecessary medical services, they may be attracting government attention and a possible fraud investigation. In many cases, the government allows a company to keep operating while it accumulates more evidence to build its case.
As a result, government agents prepare their prosecutions thoroughly. Any healthcare billing investigation has the potential to carry enormous criminal consequences.
Source: CNBC, “Nationwide Medicare Fraud Bust Among the Biggest Yet,” Scott Cohn, Oct. 4, 2012