Expanded team gets tougher on health care cheats
Published: 2009-09-27 23:10:50
Author: Jay Greene | Crains Detroit | September 6, 2009
It is well known that Michigan and metro Detroit have a great national reputation for health care quality and innovation. Many top providers — including the University of Michigan Health System and Henry Ford Medical Group — are based in the state.
But Detroit also is known as a top region for health care fraud, which is why the federal government has targeted Southeast Michigan and assigned eight FBI agents and three additional prosecutors to beef up investigations, seek indictments, send people to jail and collect fines and restitutions.
Over the past nine months, the Detroit Medicare Health Care Fraud Strike Force has announced two major sets of indictments involving nearly 60 health care executives and medical providers, said U.S. Attorney Terrence Berg in Detroit.
The providers were indicted for allegedly billing Medicare for services, including infusion therapy, physical therapy and home health services, that were either unnecessary or never provided, Berg said.
Other areas targeted by Medicare fraud investigators include durable medical equipment companies, occupational therapy and rehabilitation providers.
Hospitals, physician clinics and nursing homes also may become targets, depending on tips from whistle-blowers or suspicious billing trends, Berg said.
“We have quadrupled the number of cases” we investigate and prosecute in Detroit,” said Berg. “Between May and late June, we charged 53 people. By announcing them all at once, this will have a more of a deterrent effect than if we just charged one at a time.”
The Detroit fraud strike force is part of a larger, national Health Care Fraud Prevention and Enforcement Team, known as HEAT. It includes the FBI, the U.S. Department of Justice, the Centers for Medicare and Medicaid Services, the Department of Health and Human Services' Office of Inspector General and Blue Cross Blue Shield of Michigan.
The nearly 30-member Detroit health fraud task force includes the eight full-time FBI agents, four prosecutors and about 15 investigators working on cases, Berg said.
“That is a real difference in terms of manpower. Each one of our attorneys team up with FBI agents, OIG agents and Blue Cross if fraud is involved,” Berg said.
Since March 2007, more than 300 providers have been indicted in similar investigations in Miami, Los Angeles, Houston and Detroit for suspicion of falsely billing Medicare for more than $700 million.
Full story
Published: 2009-09-27 23:10:50
Author: Jay Greene | Crains Detroit | September 6, 2009
It is well known that Michigan and metro Detroit have a great national reputation for health care quality and innovation. Many top providers — including the University of Michigan Health System and Henry Ford Medical Group — are based in the state.
But Detroit also is known as a top region for health care fraud, which is why the federal government has targeted Southeast Michigan and assigned eight FBI agents and three additional prosecutors to beef up investigations, seek indictments, send people to jail and collect fines and restitutions.
Over the past nine months, the Detroit Medicare Health Care Fraud Strike Force has announced two major sets of indictments involving nearly 60 health care executives and medical providers, said U.S. Attorney Terrence Berg in Detroit.
The providers were indicted for allegedly billing Medicare for services, including infusion therapy, physical therapy and home health services, that were either unnecessary or never provided, Berg said.
Other areas targeted by Medicare fraud investigators include durable medical equipment companies, occupational therapy and rehabilitation providers.
Hospitals, physician clinics and nursing homes also may become targets, depending on tips from whistle-blowers or suspicious billing trends, Berg said.
“We have quadrupled the number of cases” we investigate and prosecute in Detroit,” said Berg. “Between May and late June, we charged 53 people. By announcing them all at once, this will have a more of a deterrent effect than if we just charged one at a time.”
The Detroit fraud strike force is part of a larger, national Health Care Fraud Prevention and Enforcement Team, known as HEAT. It includes the FBI, the U.S. Department of Justice, the Centers for Medicare and Medicaid Services, the Department of Health and Human Services' Office of Inspector General and Blue Cross Blue Shield of Michigan.
The nearly 30-member Detroit health fraud task force includes the eight full-time FBI agents, four prosecutors and about 15 investigators working on cases, Berg said.
“That is a real difference in terms of manpower. Each one of our attorneys team up with FBI agents, OIG agents and Blue Cross if fraud is involved,” Berg said.
Since March 2007, more than 300 providers have been indicted in similar investigations in Miami, Los Angeles, Houston and Detroit for suspicion of falsely billing Medicare for more than $700 million.
Full story