The nation’s crackdown against Medicare fraud escalated Wednesday, with the most arrests in a single day announced in Detroit and six other U.S. cities with major fraud problems.
In all, 107 people, charged with bilking $452 million in false billings from Medicare, were named in indictments brought by the U.S. Justice Department.
Twenty-two of the people indicted were from metro Detroit, including four licensed social workers.
The 22 were charged with $58 million in fraudulent billings, often for services that never were rendered or that were medically unnecessary, the indictments charged.
Home health care fraud remains one of metro Detroit’s top Medicare fraud problem areas, officials said.
Staff at the homes — which serve poor people with psychiatric problems or developmental disabilities — give painkillers and other prescription medicines, as well as cash kickbacks, to residents in exchange for their Medicare information, said Gejaa Gobena, assistant chief attorney general in the Detroit office.
Other times, health care providers, licensed social workers and their staffs used well-practiced schemes in which paid recruiters hung out on street corners and near soup kitchens and homeless shelters to obtain Medicare information from recipients, he said.
Psychotherapy or counseling services also appear to be a new area for fraud. The indictments underscore how important it is for health care workers to protect their own licensing information, federal officials said.
In one of the Detroit indictments, Funderburg Clinical and Community Services, with psychotherapy clinics in Detroit and Southfield, submitted $3 million in fraudulent billings. Controller Sayani Edwards, 32, of Taylor and Angel Williams, 27, of Southfield, an office manager, are charged with billing Medicare using provider numbers of licensed social workers without their knowledge or permission for services not needed or performed, according to the indictment.
The indictments also show the extent to which some health care providers go to hide their profits by using international bank accounts.
Wednesday’s indictments were the fourth in a series of such operations in the last two years, Assistant Attorney General Lanny Breuer said in Washington.
“These fraud schemes were committed by people up and down the chain of health care providers — from doctors, nurses and licensed clinical social workers to office managers and patient recruiters,” Breuer said.
The arrests come as top lawmakers appealed to health care professionals in the private sector to help combat Medicare fraud. Six members of the Senate Finance Committee, led by ranking member Orrin Hatch, R-Utah, and Chairman Max Baucus, D-Mont., announced a bipartisan effort to begin soliciting ideas from interested stakeholders in the health care community looking for a fresh perspective and potential solutions that may have been overlooked.
By Patricia Anstett and Tresa Baldas Detroit Free Press Staff Writers
Originally seen on http://wchbnewsdetroit.com/