There is no doubt that the federal government is cracking down on Medicare fraud. With the national debt steadily creeping upwards and some lawmakers looking for reasons to cut the program, the government has become more aggressive in its pursuit of charges related to healthcare fraud. Unfortunately, this sometimes results in innocent people getting caught in a widely thrown net and needing the help of attorneys to defend against federal charges.
Incidentally, since 2007 the Medicare Fraud Strike Force has pressed charges against a total of 1,330 people who were collectively accused of fraudulently billing Medicare for over $4 billion. Recently, three Detroit social workers fell into that category.
They pleaded guilty to conspiracy to commit healthcare fraud for perpetuating a scheme that attempted to defraud Medicare out of $3.1 million. The investigation was conducted by the FBI and the Department of Health and Human Services.
According to court records, the Detroit residents operated a company called New Century Adult Day Program Services LLC in Flint, Michigan. From November 2009 to April 2012, the three defendants apparently billed Medicare for services that were never rendered. The defendants were accused of attracting Medicare recipients to their business by promising patients medication.
Once in the office, the social workers allegedly told the patients they were required to sign up for psychotherapy services before they could see a doctor. The defendants would then use the patients' signatures on registration forms to create documents billing Medicare for the services.
Out of the amount billed, Medicare paid $740,394. All three Detroit residents face up to 10 years in prison and a $250,000 fine. Two of the defendants are scheduled for sentencing on Jan. 8, 2013, while the third is scheduled for Jan. 29, 2013.
Source: FBI.gov, "Detroit-Area Resident Pleads Guilty to Participating in $3.1 Million Medicare Fraud Scheme," Aug. 22, 2012
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