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89 arrested in sweep for Medicare fraud

Health providers are among the accused. The health law has increased penalties.

WASHINGTON - Doctors, nurses and other licensed medical professionals were among 89 people recently arrested in nine cities, accused of scheming to defraud the Medicare program of nearly $223 million in false billings, the Obama administration said Tuesday.

The defendants face charges of conspiracy to commit health-care fraud, money laundering and violating federal anti-kickback statutes for submitting claims to Medicare for purchases, treatments and services that, according to federal officials, either were medically unnecessary or never provided.

In many cases, patient recruiters, Medicare recipients and others were paid cash to supply beneficiary information that later was used in billing scams, federal law enforcement officials said. Most of the alleged fraud involved home health care services, but the charges included mental health services, psychotherapy, physical and occupational therapy, durable medical equipment and ambulance services.

"Today we're sending a strong, clear message to anyone seeking to defraud Medicare: You will get caught and you will pay the price," Health and Human Services Secretary Kathleen Sebelius said in a news conference. She credited the 2010 health-care law, the Patient Protection and Affordable Care Act, with strengthening criminal penalties for Medicare fraud and allowing the health department to suspend payments to providers when fraud is suspected.

In Miami, a hotbed for Medicare fraud, two nurses and a paramedic were among 25 people arrested this week on suspicion of submitting $44 million in false claims. In one case, the lead defendant at a Miami home health care agency, Trust Care Health Services, is accused of using proceeds from a $20 million billing scheme to buy luxury cars: two Lamborghinis, a Ferrari, and a Bentley.

The arrests were part of the sixth national crackdown on Medicare fraud carried out by the Medicare Fraud Strike Force, a special unit of the Department of Justice and HHS. Since its creation in 2007, the strike force has charged more than 1,500 people with making more than $5 billion in fraudulent claims against Medicare.