Strike Force Moves to Brooklyn, Tampa, Baton Rouge—and Shoe Inserts

WASHINGTON — “Medicare fraud schemes are driven by
greed—pure and simple,” said Assistant Attorney General Lanny
A. Breuer of the U. S. Department of Justice Criminal Division. At
a press conference yesterday, Breuer and HHS Secretary Kathleen
Sebelius announced the Medicare Fraud Strike Force had expanded its
efforts to combat fraudsters in Brooklyn, N.Y.; Tampa, Fla.; and
Baton Rouge, La., using data analysis to identify “the worst
offenders” in those areas.

The Strike Force began operations in Miami in March 2007 and
subsequently added Los Angeles, Detroit and Houston to its
roster.

The recent three-city expansion is part of the Health Care Fraud
Prevention & Enforcement Action Team (HEAT), a joint DOJ-HHS initiative
announced in May. The HEAT taskforce includes law enforcement
agents, prosecutors and staff from both departments and their
operating divisions. Each of the Strike Force teams is led by a
federal prosecutor from the respective U.S. Attorneys’ Office or
the Criminal Division’s Fraud Section, and each team has an
agent from the FBI and HHS-OIG.

Since its inception, the Strike Force has obtained indictments
of more than 460 individuals and organizations that have falsely
billed the Medicare program for more than $1 billion, according to
HHS.

“Rather than waiting for people to come forward and tell us that
fraud is happening, we’re coming to the fraud and stopping it
before it happens,” Breuer said of the Strike Force model. Once
data analysis points up a potential area of abuse, cases then are
pursued with traditional law enforcement techniques.

Breuer also announced the indictments of 32 individuals in
Miami, Detroit and Brooklyn. Collectively, the physicians, business
owners, executives and others charged in the indictments are
accused of conspiring to submit $61 million in false claims.

“In Detroit, we allege that the defendants fraudulently billed
Medicare for physical and occupational therapy as well as
diagnostic testing. In Miami, it is fraudulent HIV infusion clinics
and the most recent trend—fraudulent billing related to home
health care. And here in New York, where we are just getting
started, we’ve already seen fraud schemes involving durable medical
equipment and diagnostic testing,” Breuer said.

The New York (Brooklyn) case involves two defendants alleged to
have billed Medicare for shoe inserts for diabetes when, in fact,
cheaper over-the-counter shoe inserts were provided to
beneficiaries who often did not need them, prosecutors said.

At the press conference, Benton J. Campbell, U.S. attorney for
the Eastern District of New York, showed a pair of $10 OTC inserts
he said the defendants provided to patients while billing for more
expensive diabetes inserts that cost up to $180.