HOUSTON — Thirty-two people, including doctors, HME owners and others, have been indicted for defrauding Medicare of $16 million in a variety of false claims schemes, according to the U.S. Department of Justice.
In what officials described as "an early morning takedown" on Wednesday, Medicare Fraud Strike Force agents executed 12 search warrants at health care businesses and homes across the Houston area and made arrests in Houston, New York, Boston and Louisiana.
Seven indictments unsealed July 29 in the U.S. District Court for the Southern District of Texas charge the defendants in fraud schemes related to false billing for "arthritis kits," power wheelchairs and enteral feeding supplies. According to the indictments, the products involved were not medically necessary or often never provided. In some cases, indictments allege that beneficiaries were deceased at the time they supposedly received the items.
A Strike Force document lists Houston area HME providers and related companies named in the indictments as Onward Group Healthcare, dba Onward Medical Supplies; KO Medical; Luant & Odera, operating as Tonni Medical Equipment and Supplies; Memorial Medical Supply; Family Healthcare Services; Trucare Medical Equipment Services; and Sefan Healthcare Services.
The Medicare Fraud Strike Force—a multi-agency team including federal, state and local investigators—was launched in March 2007, initially targeting South Florida. A year later, operations expanded to Los Angeles. Detroit was added in March 2009, followed by Houston in July. To date, the Strike Force has obtained indictments of more than 293 individuals and organizations that collectively have billed Medicare for more than $674 million, according to a DOJ release.
"Our Medicare Strike Force is striking back against health care fraud in all its forms and wherever it occurs," Deputy Attorney General David Ogden said in the release. "We will stop fraud as it's happening, using real-time data analysis of Medicare billing records."
In a statement issued Thursday, the American Association for Homecare said it "strongly supports" the Strike Force crackdown.
Last year, the association proposed a 13-point Medicare Anti-Fraud Legislative Plan to stop fraud in the HME sector and has urged its adoption by Congress. Among the provisions in the legislative proposal are more rigorous quality standards, increased penalties for fraud, mandated site inspections for new providers and real-time claims analysis.
"We have zero tolerance for illegal activity," said AAHomecare President Tyler Wilson. "Eliminating fraud and abuse will benefit patients and seniors by lowering costs and increasing quality of care. We urge Congress to adopt new regulations, like those outlined in our 13-point plan, and we support tough enforcement actions, like those carried out by the Medicare Fraud Strike Force."
In May, HHS Secretary Kathleen Sebelius and Attorney General Eric Holder announced a joint initiative to reduce Medicare and Medicaid fraud called the Health Care Fraud Prevention & Enforcement Action Team, or HEAT. The takedown in Houston was the third major sweep since the effort began.
