Medicare Fraud strike force charges 89 individuals for approximately $223 million in false billing
Attorney General Eric Holder and HHS Secretary Kathleen Sebelius announce a nationwide takedown by Medicare Fraud Strike Force operations in eight cities.
HHS would increase rewards for reporting fraud to nearly $10 million
Health and Human Services Secretary Kathleen Sebelius today announced a proposed rule that would increase rewards paid to Medicare beneficiaries and others whose tips about suspected fraud lead to the successful recovery of funds to as high as $9.9 million.
HHS Report to Congress on Progress of
Report to Congress Fraud Prevention System, First Implementation Year, September 2012.
- Read the Report (PDF – 3.7MB)
The Centers for Medicare & Medicaid Services strives to make information accessible to all. Nevertheless, portions of this report may be difficult to read using assistive technology. People with disabilities having problems accessing this report may send an email to 508_Compliance@cms.hhs.gov.
Public/Private Partnership unites to fight fraud
A new partnership to fight fraud unites public and private organizations. Participants include federal and state governments, insurers, and a number of groups working to fight health care fraud.
November 20, 2013
New Jersey- Prominent Tri-State Cardiologist Sentenced To 78 Months in Prison for Record, $19 Million Billing Fraud Scheme, Exposing Patients to Unnecessary Medical Treatment
NEWARK, N.J. - A well-known cardiologist and the founder, CEO and sole owner of two large medical services companies in New Jersey and New York was sentenced today to 78 months in prison and ordered to pay $19 million in restitution for conspiring in a multimillion-dollar health care fraud scheme that subjected thousands of patients to unnecessary tests and potentially life-threatening, unneeded treatment, as well as treatment by unlicensed or untrained personnel.
November 19, 2013
California- Nursing Home Operator to Pay $48 Million to Resolve Allegations Those Six California Facilities Billed for Unnecessary Therapy
The Ensign Group Inc., a skilled nursing provider based in Mission Viejo, Calif., that operates nursing homes across the western U.S. has agreed to pay $48 million to resolve allegations that it knowingly submitted to Medicare false claims for medically unnecessary rehabilitation therapy services, the Justice Department announced today. Six of Ensign's skilled nursing facilities in California allegedly submitted the false claims: Atlantic Memorial Healthcare Center, located in Long Beach; Panorama Gardens, located in Panorama City; The Orchard Post-Acute Care (a.k.a. Royal Court), located in Whittier; Sea Cliff Healthcare Center, located in Huntington Beach; Southland, located in Norwalk; and Victoria Care Center, located in Ventura.
November 14, 2013
Louisiana- New Orleans Doctor Sentenced For Involvement in Health Care Fraud Scheme
Baton Rouge, LA - Acting United States Attorney Walt Green announced today that Dr. Anthony Stephen Jase, 44, of New Orleans, Louisiana, was sentenced to 15 months in prison and ordered to pay $360,293 in restitution for his convictions on health care fraud.
September 3, 2013
Texas - Peter Pedro Egede was arrested in Houston. He is awaiting sentencing.
Peter Pedro Egede was indicted on charges of conspiracy to commit health care fraud and health care fraud. Egede admitted that he received approximately $1.7 million in reimbursement after falsely billing Medicare and Medicaid for power wheelchairs and other durable medical equipment (DME) that he did not provide and that were not medically necessary.