Feds Uncover Healthcare Fraud Schemes in NY, TX Totaling $625 Million

Over thirty-five people have been arrested in and around New York City as part of an investigation into a healthcare fraud scheme that defrauded insurance carriers, including Medicare and Medicaid, out of as much as $250 million, according to the New York Times. Those arrested are expected to face charges that include racketeering, healthcare fraud, money laundering, insurance fraud, and wire fraud. The forthcoming charges are believed to be based on bills for unnecessary medical treatments from auto accident claims.

This news follows just one day after seven were arrested in Dallas, Texas in a home healthcare scheme that defrauded the federal government out of as much as $375 million in Medicare and Medicaid disbursements. The Texas defendants are said to have registered homeless people for healthcare services never rendered, and the scheme is described as “staggering in its breadth and scope” by federal prosecutors and as the largest known fraud perpetrated by a single doctor to date.

While it is not yet clear what led to the discovery of the NY insurance fraud, the discovery of the Texas operation grew out of newly-administered computer analysis techniques that search for suspicious billing patterns. Since 2009, as reported by the New York Times, the Department of Justice as charged more than 800 defendants with fraud totaling more than $2.2 billion.

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