FBI – Health Care Fraud Takedown Targets $295 Million in False Medicare Claims


FBI Executive Assistant Director Shawn Henry, left, is joined by Attorney General Eric Holder and HHS Secretary Kathleen Sebelius in announcing a nationwide Medicare fraud takedown operation.

Health Care Fraud Takedown
Targets $295 Million in False Medicare Claims

In Houston, two individuals were charged today with Medicare fraud schemes involving $62 million in false claims for home health care and durable medical equipment. According to the indictment, one of the defendants sold Medicare beneficiary information to 100 different Houston-area home health care agencies, and the agencies used that information to bill Medicare for services that were unnecessary or not even provided.

National Medicare Fraud Takedowns

– February 2011: 111 Charged for More Than $125 Million in False Billings

– July 2010: 94 Doctors and Providers Charged With $251 Million in False Billings

– December 2009:Operations Lead to 30 Indictments in Miami, Detroit, and Brooklyn

More HEAT Task Force news

But that’s just the tip of today’s enforcement iceberg: this afternoon, Attorney General Eric Holder, FBI Executive Assistant Director Shawn Henry, and other officials announced a nationwide takedown that took place over the past week involving Medicare Fraud Strike Force operations in seven other cities as well—Baton Rouge, Brooklyn, Chicago, Dallas, Detroit, Los Angeles, and Miami. A total of 91 individuals were charged with various Medicare fraud-related offenses, including fraudulent billings of approximately $295 million, the largest amount in phony claims involved in a single takedown in Strike Force history.

The Medicare Fraud Strike Force, coordinated jointly by the Department of Justice (DOJ) and the Department of Health and Human Services (HHS), is a multi-agency team of federal, state, and local investigators who combat Medicare fraud by analyzing data about the problem and putting an increased focus on community policing. The strike force is part of the Health Care Fraud Prevention and Enforcement Action Team (HEAT), another joint DOJ-HHS initiative that works to prevent and deter fraud…and enforce current anti-fraud laws. The strike force currently operates in nine U.S. cities (the eight cities mentioned previously, plus Tampa) in areas victimized by high levels of health care fraud.

Other cases announced today include:

	Has anyone approached you in a public area and offered FREE services, groceries, or other items in exchange for your Medicare number? JUST WALK AWAY! Has someone called you for a “health survey,” then asked you to provide your Medicare number over the phone? SIMPLY HANG UP THE PHONE! Have you found suspicious charges such as high-priced medical services or diagnostic tests on your medical bills? These could be fraudulent charges. Call 1-800-MEDICARE AND REPORT IT! Have doctors, health care providers, or suppliers told you that the equipment or service is free, it won’t cost you anything, and they only need your Medicare number for their records? JUST SAY NO THANKS! Guard your Medicare and Social Security Numbers. Report Fraud to the Office of the Inspector General. 1-800-HHS-TIPS (1-800-447-8477) HHSTips@oig.hhs.gov More Info > Visit Website \| Share
	stopmedicarefraud.gov

In Miami, 45 individuals—including a doctor and a nurse—were charged for their participation in various fraud schemes involving a total of $159 million in fraudulent Medicare billings in the areas of home health care, mental health services, occupational and physical therapy, durable medical equipment, and HIV infusion.
In Los Angeles, six defendants—including one doctor—were charged for their roles in schemes to defraud Medicare of more than $10.7 million.
In Brooklyn, three defendants—including two doctors—were charged in a fraud scheme involving more than $3.4 million in false claims for medically unnecessary physical therapy.
In Detroit, 18 additional defendants—including doctors, nurses, clinic operators, and other health care professionals—were charged for schemes involving an additional $28 million in false billing.

In addition to our role on the Medicare Fraud Strike Force, the FBI also operates health care fraud task forces or working groups in all 56 of our field offices. Hundreds of agents and analysts—using intelligence to identify emerging schemes and tactics—are currently working more than 2,600 health care fraud investigations.

Nearly 70 percent of these cases involve government-sponsored programs, like Medicare, since the Bureau is the primary investigative agency with jurisdiction over federal insurance programs. But we also have primary investigative jurisdiction over private insurance programs, and we work closely with private insurers to address threats and fraud directed towards these programs.

Taking part in this takedown were more than 400 law enforcement personnel from the FBI, HHS-Office of Inspector General, multiple Medicare fraud control units, and state and local law enforcement agencies.

9/11-How can we survive ? – Black Humor for War Time Debt Profligacy and Panic

Black Humor for War Time Debt Profligacy and Panic

Images by Cryptome.

We Meant Well: How I Helped Lose the Battle for the Hearts and Minds of the Iraqi People, Peter Van Buren, 2011. Peter Van Buren was a State Department officer in Iraq working with Provincial Reconstruction Teams (PRTs). He was based primarily at Forward Operating Base Hammer

Van Buren provides an informative, gorge-raising, black humorous, literal boots-on-the-ground, apology for “we have a war to fight, damn the cost, others will pay the bill” instigator of the current global panic about national debt ever bleaker humor. Rue with him being taken in by the natsec scam, laugh at each other and weep over your unpaid bills, service cutbacks, and tax duns for the cost of guiltless official malfeasance.

DoJ-celebrated task force prosecutions for terrorism, financial crime, health care fraud and child pornography are easy, small-time stuff compared to the great crimes in Iraq and Afghanistan forgiven by war-time exemptions, with very few cases for US official financial profligacy, negligence and wastage.

Excerpts:

Page 11:

My side of State was removed from the high-level Wikileaky things ambassadors did and changed very little between administrations.

[Van Buren was based primarily at FOB Hammer (as was Bradley Manning), a huge base 12 miles in circumference which was heavily compartmentalized to separate types of personnel: military, USG, OG (CIA), contractors, guards, servants.]

U.S. Army 210th Brigade Support Battalion, 2nd Brigade, 10th Mountain Division Soldiers compete in remote car derby in Forward Operating Base Hammer, Iraq, July 4, 2010. U.S. Soldiers celebrated Independence Day with a series of tournaments, a cookout, and an array of games.(U.S. Army photo by Spc. Frank Smith/Released)

Pages 46-49:

Money and Our Meth Habit

We lacked a lot of things in Iraq: flush toilets, fresh vegetables, the comfort of family members nearby, and of course adult supervision, strategic guidance, and common sense. Like Guns N’ Roses’ budget for meth after a new hit, the one thing we did not lack was money. There was money everywhere. A soldier recalled unloading pallets of new US hundred-dollar bills, millions of dollars flushing out of the belly of a C-130 cargo aircraft to be picked up off the runway by forklifts (operated by soldiers who would make less in their lifetimes than what was on their skids at that moment). You couldn’t walk around a corner without stumbling over bales of money; the place was lousy with it. In my twenty-three years working for the State Department, we never had enough money. We were always being told to “do more with less,” as if slogans were cash. Now there was literally more money than we could spend. It was weird.

We’d be watching the news from home about foreclosures, and I’d be reading e-mails from my sister about school cutbacks, while signing off on tens of thousands of dollars for stuff in Iraq. At one point we were tasked to give out microgrants, $5,000 in actual cash handed to an Iraqi to “open a business,” no strings attached. If he took the money and in front of us spent it on dope and pinball, it was no matter. We wondered among ourselves whether we shouldn’t be running a PRT in Detroit or New Orleans instead of Baghdad. In addition to the $63 billion Congress had handed us for Iraq’s reconstruction, we also had some $91 billion of captured Iraqi funds (that were mostly misplaced by the Coalition Provisional Authority), plus another $18 billion donated by countries such as Japan and South Korea. In 2009, we had another $387 million for aid to internal refugees that paid for many reconstruction-like projects. If that was not enough, over a billion additional US dollars were spent on operating costs for the Provincial Reconstruction Teams. By comparison, the reconstruction of Germany and Japan cost, in 2010 dollars, only $32 billion and $17 billion, respectively.

While a lot of the money was spent in big bites at high levels through the Embassy, or possibly just thrown into the river when no one could find a match to set it on fire, at the local level money was spent via two programs: CERP and QRF. CERP was Army money, the Commander’s Emergency Response Program. Though originally provided to address emergency humanitarian needs and short-term counterinsurgency costs, this nearly unlimited pool of cash came to be spent on reconstruction. The local US Army Commander could himself approve projects up to $200,000, with almost no technical or policy oversight. Accounting was fast and loose; a 2009 audit, for example, found the Army could not account for $8.7 billion in funds. It might have been stolen or just lost; no one will ever know. The Army shared its money with us at the ePRTs, partly out of generosity, partly out of pity, and partly because individual military units were graded on how much cash they spent — more money spent meant more reconstruction kudos in evaluation reports.

Pages 56-57:

Garbage

In our air-conditioned isolation, it took years to realize we needed to think about things like garbage and potable water. What had happened all around Iraq since the chaos of 2003 was a process of devolution, where populated areas lost their ability to sustain the facilities that had constituted civilization since the Romans — water, sewage, trash removal — things that made it possible for large numbers of people to live in close proximity to one another. Shock and awe had disrupted the networked infrastructure that allowed cities to function. What had been slow degradation through neglect under Saddam became irreversible decline by force under the United States.

The collapse of civil society left a void that the bad guys had rushed to fill. Stories circulated of neighborhood militiamen commandeering shuttered power plants and private generators for the public’s use, turning the militants into local heroes. In some poor areas, especially in the south, Iranian charities were a primary source of propane, food, and other services that people expected the government to provide, as Saddam had more or less done. It had finally dawned on us that providing reliable basic utilities was critical to a successful counterinsurgency. The Provincial Reconstruction Teams (PRTs) were put on the case after earlier efforts by megacontractors like Bechtel and then the Army Corps of Engineers had failed.

Almost daily my team and I would go out into the field. We’d strap on body armor and helmets and load into armored vehicles for the soldiers to drive us out of the FOB. We rode in either armored Humvees or large monster trucks called MRAPs, mine-resistant, ambush-protected carriers. These sat high off the ground and were covered with antennas and crazy electronics designed to thwart the battery-powered triggers that set off IEDs and mines along our route. The best thing about the MRAPs was that they were hermetically sealed against nonexistent chemical weapons and thus possessed near-nuclear-powered air-conditioning. You could crank that stuff and form frost. The MRAPs were so high off the ground that the turret often tore down the spaghetti web of pirated electric lines strung over most streets, lessening our popularity every time we drove in. Our parade of four or five vehicles, armed with nasty-looking machine guns and tough-looking soldiers, would nonetheless roll through small towns and slums to arrive at whatever dilapidated building served as the center of US-appointed local government. (By common consent no one was allowed to comment on the paradox of creating a democracy by appointing local leaders. It just wasn’t done.) As we drove, trash was a fact anywhere we looked, like the sun and the dust. The MRAPs specifically equipped to look for roadside bombs even had giant blowers welded to their front bumpers to whip garbage aside and expose the IEDs. For a poor country, everybody seemed to have a lot of things to throw away. Even though the trash was rarely collected, there were huge dumps filled with acres of it. You couldn’t help but be reminded that for all the counterinsurgency ideals about living among the people, we still lived near Iraq but not in it; on the FOB you couldn’t drop a Snickers wrapper without two people telling you to pick that shit up.

[Image]

Mine Resistant Ambush Protected vehicles secure a local village while members of Provincial Reconstruction Team Zabul conduct a key leader engagement with village elders in Arghandab, Afghanistan, July 30, 2011. PRT Zabul’s mission is to conduct civil-military operations in Zabul Province to extend the reach and legitimacy of the Government of Afghanistan. (U.S. Air Force photo/Senior Airman Grovert Fuentes-Contreras)(Released)

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