$61M Medicare fraud crackdown

One of President Obama’s thrusts when he became president was to combat Medicare fraud. Obama promised to crackdown on criminals who steal millions of dollars from Medicare through fraudulent claims.

To pursue this commitment, the joint DOJ-HHS Medicare Fraud Strike Force had been tasked to combat Medicare fraud by using Medicare data analysis techniques and increasing focus on community policing. The strike force operated in various cities like Los Angeles, Miami, Detroit, Brooklyn, Houston, Tampa and Baton Rouge.

In one of the major crackdowns in Medical fraud, the strike force was able to arrest 26 suspects including one doctor and several nurses. The suspects were accused of running a scam to tap a Medicare program that paid very high rates to patients. Moreover, these suspects allegedly billed Medicare for unnecessary medical equipment, physical therapy and HIV infusions.

With Medicare fraud, the cost of health care had been raised causing additional burden to American taxpayers. Consequently, when the healthcare system had been defrauded, all Americans were being defrauded. Thus, this issue should be a concern for everyone.

The above suspects were still presumed innocent until proven otherwise. To prove their innocence, they need to hire a Medicare fraud defense lawyer.

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42 arrests in a $4.6 million Medi-Cal fraud case

Healthcare is a basic human need. People go to hospitals or medical providers to get the best health care services.

When patients are being treated by unlicensed medical providers, health is compromised and fraudulent acts become imminent. Some patients even deserve specific treatment that only qualified and licensed individuals could provide.

To spare more individuals from unlicensed medical providers, authorities launched “Operation License Integrity’’. As a result, 42 individuals were arrested, 20 of whom were Orange, Los Angeles and Riverside counties residents. The arrests were due to their alleged participation in a $4.6 million Medi-Cal fraud case. Allegedly, unlicensed individuals were used to provide care to disabled patients including children with cerebral palsy.

Priscilla Villabroza, a registered nurse and manager of Medicare Plus Home Health Providers, was accused as the scheme’s mastermind. She employed unlicensed individuals from 2004 to 2007 to provide care to disabled patients, and then billed Medi-Cal as if they were licensed vocational nurses. Worse, some of those hired lack medical training.

Villabroza already pleaded guilty to five counts of health care fraud in 2008. Susan Bendigo, Villabroza’s assistant, was also indicted but remained at large. All other accused were charged with health fraud and conspiracy to commit health care fraud.

Health care providers and personnel are expected to deliver proper health care. Providing health care without a license is a serious crime which entails a serious punishment. Moreover, patients who had been given wrong treatment may file an appropriate case against these providers.

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