Lucky Number 7


The number seven has long been considered to be lucky, especially for the Medicare Fraud Strike Force, which recently made its seventh most notable crackdown since launched in 2007. (Notice the number of sevens?) An article in The Wall Street Journal reports that in this seventh major bust, 90 people across the country were charged with generating approximately $260 million fraudulent Medicare billings. (My guess is that these defendants are not feeling so lucky at the moment.)

The story states that raids were conducted from Miami to Los Angeles, affecting doctors who allegedly received kickbacks for referring Medicare patients to companies selling durable medical equipment. The bust also found additional suspects in Tampa who supposedly billed the benefits program for services provided to beneficiaries who lived 280 miles away in Miami-Dade County.

One doctor from New York was noted as allegedly billing for services he did not provide. He is accused of submitting $85 million in bogus claims to Medicare over a two-year period and authorities say he received $7 million. Six days after this doctor was interviewed by investigators, he allegedly wired $2 million to his native country of Pakistan. (He is currently being held without bail because he is considered to be a flight risk.) Another doctor was arrested in Hollywood for purportedly prescribing unnecessary medical equipment and home health services to Medicare beneficiaries.

Congratulations to the Medicare Fraud Strike Force for their commitment to protect our nation’s senior citizens against fraud. Over the past seven years, this joint effort between the Department of Justice and the Department of Health and Human Services has charged 1,900 people who have allegedly billed $6 billion to the benefits program. (As always, remember that those charged in this case are considered innocent until proven guilty. The fate of these 90 people will be up to the judicial system to determine if they have run out of luck.)

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Task Force Accuses 90 of Bilking Medicare,” written by John Carreyrou and Christopher S. Stewart and published in The Wall Street Journal on May 13, 2014.

A federal task force on Tuesday charged 90 people, including 16 doctors, with generating $260 million of false Medicare billings following raids in cities across the country.

The arrests mark the seventh notable crackdown by the Medicare Fraud Strike Force, a joint effort of the Justice Department and the Department of Health and Human Services launched in 2007.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.