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107 charged in Medicare fraud crackdown

The latest Medicare fraud crackdown involves bogus claims totaling $452 million, officials say. Arrests are made in seven cities, including Los Angeles.

May 02, 2012|By Richard A. Serrano, Washington Bureau
  • Federal agents take away computers from Willsand Home Health Agency Inc. in Miami.
Federal agents take away computers from Willsand Home Health Agency Inc.… (Alan Diaz, Associated Press )

WASHINGTON — Doctors, nurses and social workers from across the country, 107 in all, were charged in what federal officials in Washington called a "nationwide takedown" of medical professionals accused of fraudulently billing Medicare out of nearly half a billion dollars.

The amount of bogus Medicare claims, totaling about $452 million, was the highest in a single raid in the history of a federal strike force combating rising fraud in the medical industry, according to the Justice Department. Arrests were made in seven major cities.

The Obama administration said it was toughening its attack on those who filed bills for ambulance rides never taken and medical procedures never provided.

In addition, officials in the Health and Human Services Department suspended or took other administrative actions against 52 medical providers after analyzing billing requests and finding additional "credible allegations of fraud."

In the Los Angeles area, eight people, including two doctors, were charged with fraudulently billing about $20 million for services never provided.

Bolademi Adetola, owner of healthcare equipment provider Latay Medical Services in Gardena, was charged with billing Medicare for power wheelchairs that were never purchased. Greatcare Home Health in Los Angeles allegedly paid kickbacks to recruiters to find "patients" who were perfectly fine, and then have doctors knowingly write phony prescriptions for them.

Dr. Augustus Ohemeng and Dr. George Tarryk, who treated patients at the Pacific Clinic in Long Beach, were among four individuals who allegedly falsely billed for feeding tubes for patients who did not need them.

None of the defendants or their lawyers could be reached for comment.

Assistant Atty. Gen. Lanny Breuer, head of the Justice Department's criminal division, said the arrests, fourth in a series of Medicare fraud takedowns over the last two years, served as another warning to future scammers.

"Medicare is an attractive target for criminals," Breuer said, even as prosecution and jail time is risked with every false claim.

"If you don't believe it," he said, "ask Lawrence Duran, the former owner of a mental healthcare company in Miami who was sentenced last year to 50 years in prison. Or his two co-owners, each of whom was sentenced to 35 years."

Of the 107 defendants in the latest crackdown, 87 were arrested Wednesday. Federal agents were either still looking for the others or expecting them to surrender voluntarily.

The other cities were Miami; Tampa, Fla.; Houston; Baton Rouge, La.; Detroit and Chicago.

The Obama administration has stepped up efforts to combat fraud in the Medicare program, which provides health coverage to about 50 million elderly and disabled Americans.

Last year the federal government charged 1,430 people with healthcare fraud, up from 797 in 2008, according to the Health and Human Services Department. The agency also reported revoking the eligibility of more than 60,000 Medicare and Medicaid providers and suppliers and recovering $4.1 billion in fraudulent claims.

Although there is broad agreement that fraud is widespread in Medicare and Medicaid, estimates of the scope of the program vary from $20 billion a year to $100 billion. Total spending on Medicare and Medicaid is expected to reach about $1 trillion this year.

Louis Saccoccio, chief executive of the National Health Care Anti-Fraud Assn., said the latest round of arrests was encouraging and reflected the intensified efforts by the government to combat fraud, especially since 2009.

He said he was most pleased to see that the Health and Human Services Department had stopped payments to 52 providers by using new tools to analyze data and detect potentially fraudulent charges.

The system, which was set up by the healthcare law President Obama signed two years ago, relies on a computer program to identify patterns of potentially fraudulent charges by providers. "That really has the promise to be a game changer," he said. "In the future, what you will see is the real impact is going to come from preventing fraud."

richard.serrano@latimes.com

Times staff writer Noam N. Levey contributed to this report.

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