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CBP Field Operations Personnel in Florida Recognized for Role in Largest Health Care Fraud Takedown in History

Release Date: 
September 15, 2016

MIAMI - Department of Health and Human Services Office of Inspector General leadership in Florida officially recognized U.S. Customs and Border Protection personnel along with state and federal law enforcement partners this week for supporting the largest health care fraud takedown in history. An unprecedented nationwide sweep in June led by the Medicare Fraud Strike Force in 36 federal districts, resulted in criminal and civil charges against 301 individuals, including 61 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $900 million in false billings.

Courtesy Department of Justice

“Health care providers and patients are key to protecting the Medicare and Medicaid programs, but when they instead choose to commit fraud or to lie in order to obtain government benefits they are not entitled to, they steal precious tax dollars and corrupt the integrity of our health care system,” said Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health & Human Services Office of Inspector General (HHS OIG). "We count on partners such as U.S. Customs and Border Protection. This takedown reflects the dedication of OIG and our law enforcement partners to bring such fraudsters to justice."

For the Strike Force locations, in the Southern District of Florida, a total of 100 defendants were charged with offenses relating to their participation in various fraud schemes involving approximately $220 million in false billings for home health care, mental health services and pharmacy fraud.  In one case, nine defendants have been charged with operating six different Miami-area home health companies for the purpose of submitting false and fraudulent claims to Medicare, including for services that were not medically necessary and that were based on bribes and kickbacks.  In total, Medicare paid the six companies over $24 million as a result of the scheme.

In Tampa, Orlando and elsewhere in the Middle District of Florida, 15 individuals were charged with participating in a variety of schemes including compounding pharmacy fraud and intravenous prescription drug fraud involving $17 million in fraudulent billing.  In one case, the owner of several infusion clinics allegedly defrauded the Medicare program of over $8 million through a scheme involving reimbursement claims for expensive intravenous prescription drugs that were never purchased and never administered to patients.

“CBP is committed to fighting fraud with the unparalleled support of an ever-expanding network of law enforcement partners in Florida and this latest commendation is a testament to the professionalism and dedication of our Officers,” said Diane J. Sabatino, Director Field Operations for Miami and Tampa Field Offices. “CBP enforces more than 400 laws and regulations for 40 different agencies and will continue to work alongside local, state, and federal government partners everyday to protect the public.”

According to court documents, the defendants allegedly participated in schemes to submit claims to Medicare and Medicaid for treatments that were medically unnecessary and often never provided.  In many cases, patient recruiters, Medicare beneficiaries and other co-conspirators were allegedly paid cash kickbacks in return for supplying beneficiary information to providers, so that the providers could then submit fraudulent bills to Medicare for services that were medically unnecessary or never performed.  Collectively, the doctors, nurses, licensed medical professionals, health care company owners and others charged are accused of submitting a total of approximately $900 million in fraudulent billing.

Miami/Tampa Director of Field Operations Diane Sabatino meets with HHS OIG
Miami/Tampa Director of Field Operations
Diane Sabatino meets with HHS OIG

The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative announced in May 2009 between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.  The Medicare Fraud Strike Force operates in nine locations and since its inception in March 2007 has charged over 2,900 defendants who collectively have falsely billed the Medicare program for over $8.9 billion.

CBP Office of Field Operations in Florida includes travel and trade facilitation and securing over 1,200 miles of the coastal border. Follow U.S. Customs and Border Protection operations in Florida at @CBPFlorida on Twitter for updates.

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Media Materials: National Health Care Fraud Takedown 2016

Last modified: 
February 9, 2017