More Than 200 Arrested in Medicare Fraud Crackdown: A Reactionary or Just Cause?

Following the largest healthcare fraud crackdown in U.S. history, some question whether such mass arrests are an overzealous response to national frustration.

Dallas, Tx, 08/04/2015 / /

Recently, the U.S. Justice Department arrested 243 people nationwide in connection with a crackdown on healthcare fraud. Department officials announced on June 18 that among those charged over the course of several days were doctors, nurses, and other medical professionals accused of carrying out acts that have contributed to $712 million in false Medicare billing.


Source: CNBC Report “Medicare fraud bust charges 243 across nation”


“The cases, which span 17 federal judicial districts, are not all related to each other. But they all involve alleged fraud on Medicare, the federal program that provides health-care benefits to primarily senior citizens, as well as on Medicaid, the government health program for the poor.”


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The Department of Justice Office of Public Affairs released a press release announcing the mass arrests, stating that the Centers for Medicare & Medicaid Services (CMS) also suspended several providers in the coordinated effort.


Source: U.S. Department of Justice “National Medicare Fraud Takedown Results in Charges Against 243 Individuals for Approximately $712 Million in False Billing”


“The defendants are charged with various health care fraud-related crimes, including conspiracy to commit health care fraud, violations of the anti-kickback statutes, money laundering and aggravated identity theft.  The charges are based on a variety of alleged fraud schemes involving various medical treatments and services, including home health care, psychotherapy, physical and occupational therapy, durable medical equipment (DME) and pharmacy fraud. “


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Director James Comey is quoted in the Department’s release as stating, “Health care fraud is a crime that hurts all of us and each dollar taken from programs that help the sick and the suffering is one dollar too many.” Since 2007, a reported estimate of 2,300 people have been charged with falsely billing the Medicare program over $7 billion.


Although many are applauding the federal government’s takedown, some question whether such mass arrests are really aimed at addressing problems within the healthcare system, or are primarily focused on providing a response to underlying national frustrations.


A Less Popular Take on the Recent Health Care Fraud Arrests


Texas based criminal defense attorney Mick Mickelsen suggests that although many expressed concerns about major health care fraud are statistically supported, “the government has a huge incentive to be seen as tough on healthcare fraud” regardless. Mass arrests as this send the message that something is being done to fix problems on a broad scale and tone down a barrage of long-standing complaints.


Mickelsen says the same is true for any type of national frustration where the government is expected to boldly act to address the concerns of citizens. “Historically, this is always true. If people are frustrated with an influx of undocumented people to our borders, the government has cracked down on immigration related crimes. If people are frightened by the threat of terrorism the government will aggressively pursue any case to which it can attach the terrorism label.”


Consequences of An Overzealous Reaction


If there is an overzealous reaction to matters like health care fraud; however, major problems can arise. The attorney states that in some cases, innocent people are thrown into the mix, and may, in the worst-case scenario, be found guilty when they have done nothing consciously wrong. Mickelsen stresses the importance of individuals who are charged with healthcare fraud to understand how to protect their legal rights and to receive a fair judicial process. Because the legal area is a complicated and difficult one, it is advisable to contact a criminal defense attorney for a consultation about what legal options are available as soon as possible under these circumstances.



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