In a crackdown on health insurance
fraud, 94 people have been charged by the US Department of Justice
(DoJ) for participation in schemes to defraud the Medicare
programme of $251m. Among those indicted are doctors and health
care company owners.
According to the DoJ, the accused
participated in schemes to submit claims to Medicare for treatments
that were medically unnecessary and often never provided. In many
cases, beneficiaries accepted cash kickbacks in return for allowing
providers to submit forms saying they had received the treatments
that were unnecessary or never provided.
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Medicare is a government-funded
health insurance programme operated on its behalf by private health
insurers for Americans over 65 years old and others meeting certain
criteria. In 2008, Medicare provided health coverage for 45m
people.
The action was led by the Health Care Fraud Prevention and
Enforcement Action Team formed in May 2009, and involved 360 law
enforcement agents. In the state of Florida alone, indictments have
been obtained against about 810 individuals and organisations that
collectively have billed the Medicare programme for $1.85bn.
