Just weeks after the government publicized an expansion of a collaborative Medicare anti-fraud enforcement team, federal officials announced their first strike. It's likely to be the first of many to involve heightened scrutiny of physicians, according to legal experts.

As part of an ongoing effort, senior officials from the Depts. of Justice and Health and Human Services on June 24 announced criminal charges against 53 individuals -- including doctors, beneficiaries, and health care company owners and employees -- for allegedly scheming to submit a total of more than $50 million in false Medicare claims in the Detroit area.

The indictments, filed in U.S. District Court for the Eastern District of Michigan, come after a May 20 announcement by the two departments of an expansion of a joint task force-- dubbed the Health Care Fraud Prevention and Enforcement Action Team, or HEAT -- into Detroit and other areas. Programs were already under way in south Florida and Los Angeles. The Medicare Fraud Strike Forces target suspected fraudulent activities by partnering with federal, state and local law enforcement agencies in particular geographic areas suspected as hotbeds of such criminal activity.

So far, most of the fraud targeted has been in the area of infusion therapy and durable medical equipment, but some physicians have been accused of participating in the crimes. The latest indictments -- which name at least four physicians -- centered on infusion therapy, as well as physical and occupational therapy services provided in several clinics.

While the government appears to be focusing on the more egregious cases, these latest efforts indicate enforcement officials plan to cast the net wide, said Brian D. Roark, a Medicare fraud expert and partner with Bass, Berry & Sims in Nashville, Tenn.

"Clearly one of most pressing issues in the health care reform debate is ... reining in unnecessary costs, and at the top of everyone's list of unnecessary costs is fraud of the sort alleged here," he said. "We can see these indictments as further proof [the government] intends to focus on all participants in fraud, whether it's the corporation, the physician or even the patients."

Roark also noted that the cases display the range of prosecutorial tools the government has at its disposal. The indictments -- which involve no admissions of wrongdoing by any defendants -- accuse the various parties of a range of offenses, from conspiracy, to criminal false claims, to violations of federal anti-kickback statutes.

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