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Subject: Medicare Fraud Crackdown: 100 Doctors, Nurses, Social Workers Charged
 In Historic Bust
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Medicare Fraud Crackdown: 100 Doctors, Nurses, Social Workers Charged
In Historic Bust
Medicare fraud has been a hot  Obama administration button issue
By KELLI KENNEDY and PETE YOST 05/ 2/12 04:11 PM ET

MIAMI -- Federal authorities charged 107 doctors, nurses and social
workers in seven cities with Medicare fraud Wednesday in a nationwide
crackdown on unrelated scams that allegedly billed the taxpayer-funded
program of $452 million =96 the highest dollar amount in a single
Medicare bust in U.S. history.

It was the latest in a string of major arrests in the past two years
as authorities have targeted fraud that's believed to cost the
government between $60 billion and $90 billion each year. Stopping
Medicare's budget from hemorrhaging that money will be key to paying
for President Barack Obama's health care overhaul.

Health and Human Services Secretary Kathleen Sebelius and Attorney
General Eric Holder partnered in 2009 to increase enforcement by
allocating more money and staff and creating strike forces in fraud
hot spots.

On Wednesday, hundreds of federal agents fanned out around the
country, raiding businesses, seizing documents and charging 107
suspects in Miami, Los Angeles, Houston, Detroit, Chicago, Tampa,
Fla., and Baton Rouge, La. The government suspended payment to 52
providers as part of the investigations.

"When President Obama took office he asked Attorney General Holder and
me to make fraud prevention a cabinet-level priority," Sebelius said
in remarks prepared for a news conference in Washington.

Among those arrested Wednesday were the owners of two community mental
health centers in Baton Rouge, charged with billing $225 million in
their scams. Hoor Naz Jafri and Roslyn Dogan allegedly recruited
vulnerable patients, including elderly people, drug addicts and the
mentally ill. Patient charts were doctored to show services that were
billed to Medicare but often never given, according to an indictment.

Authorities suspended their companies in May 2011, but the pair
continued billing Medicare after purchasing another fraudulent
company, according to the indictment. When feds shut down that
company, the pair tried to sell their "beneficiaries" to other
providers in an attempt to keep making money.

During the investigation, federal authorities tried to put a hold on
the company's bank account. Dogan asked to visit the U.S. Attorney's
Office to review and copy documents that had been seized as part of a
search. After the visit, "Dogan and co-conspirators bragged that,
while pretending to copy files, they actually stole incriminating
documents from the files and later destroyed them." Dogan referred to
herself as a "smooth criminal," according to the indictment.

Another co-conspirator bragged to Dogan and others that he had a
"bonfire with fabricated notes that law enforcement officers had
failed to seize during the search," according to the indictment.


They could face life in prison if convicted. A woman who answered the
phone at one of the companies hung up and an email to the company was
not immediately returned.

Five others were charged in connection with the Baton Rouge scam,
capping a six-year investigation.

"The results we are announcing today are at the heart of an
administration-wide commitment to protecting American taxpayers from
health care fraud," said Attorney General Eric Holder. "We are
determined to bring to justice those who violate our laws and defraud
the Medicare program for personal gain.

More than 50 defendants were also arrested in Miami in unrelated scams
totaling $136 million involving community mental health centers and
home health care agencies. A handful of those arrested also had
criminal backgrounds, according to federal agents.

Community mental health centers are the latest trend in Medicare
fraud, which has developed more complex schemes over the years, moving
from medical equipment and HIV infusion fraud to ambulance scams, as
crooks try to stay one step ahead of authorities. The scams have also
grown more sophisticated using patient recruiters who are paid
kickbacks for recruiting patients, while doctors, nurses and company
owners coordinate to make it appear they are delivering medical
services which they are not.

"Medicare fraud also exposes some of our most vulnerable citizens to
identity theft, and, in some cases, endangers patients' lives," said
Gary Cantrell, Deputy Inspector General for Investigations for HHS.
"The indictments announced today demonstrate that we're fighting
back."

Wednesday's arrests come as top lawmakers appealed to health care
professionals in the private sector to help combat Medicare fraud. Six
members of the Senate Finance Committee, led by Ranking Member Orrin
Hatch (R-Utah) and Chairman Max Baucus (D-Mont.), announced a
bipartisan effort to begin soliciting ideas from interested
stakeholders in the health care community looking for a fresh
perspective and potentially solutions that may have been overlooked.

"To date, numerous efforts have been made to reduce fraud, yielding a
mixed record of successes and failures," according to the letter.

Sebelius said her agency and the Justice Department have more than
quadrupled the number of strike teams around the country, charging
hundreds of individuals with Medicare fraud.

Medicare fraud has been a hot button issue as federal officials have
repeatedly come under fire for seemingly staying one step behind the
criminals, using outdated technology and not coordinating efficiently
with law enforcement.

But Sebelius touted a new data system that will allow authorities to
spot trends in billing patterns more quickly, which will ideally stop
payments before they go out the door.

The Centers for Medicare and Medicaid Services launched a $77 million
computer system last summer to serve that purpose, but the program has
yielded few results in the early stages and drawn criticism from the
Senate Finance Committee.
___

Yost reported from Washington.
http://www.huffingtonpost.com/2012/05/02/medicare-fraud-crackdown-_n_147164=
2.html