5 Arrested in Tampa for Medicare Fraud

In what authorities are calling the largest national healthcare fraud takedown in U.S. history, five residents from Tampa and more than six dozen from South Florida have been accused of defrauding the Medicaid and Medicare programs.

Of the 243 arrested, many were doctors, nurses, and pharmacy owners. Included in the five people arrested in the Tampa area, was a physician who billed for services that were never rendered, according to authorities.

Nationwide Takedown Yields 5 Tampa Arrests

The charges in Tampa and South Florida were part of a nationwide takedown that involved about $712 million in false billings. According to Miami U.S. attorney Wilfredo Ferrer, they arrested doctors, therapists, clinic owners, pharmacy owners, employees of healthcare professionals, and patient recruiters.

The nationwide sweep spanned from Alaska, to California, to New York and Florida. Though the cases were unrelated, in an effort to send a message to other fraudsters and the general public, law enforcement agencies have coordinated a series of announcements.

The crackdown, the largest of its kind, primarily focused on prescription fraud. Over 40 of the arrests involved fraudsters whose scams that targeted Medicare’s drug benefit, which is expected to be the fastest-growing part of the program.

According to Gary Cantrell, the top investigator for the Health and Human Services Inspector General’s Office, their greatest concern is the prescription drug program. Cantrell said that the scams often involve billing for drugs that were never dispensed, or billing for painkillers and narcotics that end up being sold on the streets.

The five arrested in Tampa are accused of participating in various schemes, such as a multimillion dollar scheme involving fraudulent physical therapy billing, and billing for tests that were never conducted, according to the Department of Justice.

In one of the Tampa cases, a licensed pain management physician billed for nerve conduction studies and other services that were allegedly not performed. In that case, the defendant received over $1 million in reimbursement from Medicare for the purported services.

Since Medicare is legally required to pay claims promptly, it makes it so the program is vulnerable to fraud. Investigators call this “pay and chase.”

Medicare has been cracking down on fraud in the recent years by more extensive monitoring of claims before they are paid, and by imposing stiffer penalties on those found guilty of defrauding the program.

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