Eli's Rehab Report

Published on Thu May 24, 2012 PDF

Improper billings of $452 million were identified prior to arrests.

More than 150 medical professionals, including therapists, are not seeing patients this week after the Medicare Strike Force shut down doctors, nurses, therapy practices, and home health agencies during a takedown involving the highest amount of false Medicare billings in a single strike force operation.

On May 2, the Department of Health and Human Services (HHS) announced the charges against 107 individuals, with another 52 providers suspended or involved in administrative action. In total, the government alleges that about $452 million in false billing was discovered among the accused providers across the country.

The charges range from anti-kickback and false claims violations to money laundering, and involved services such as mental health treatment, physical and occupational therapy, home health, durable medical equipment, and other facets of medical care.

Detroit-area residents Zahir Yousafzai and Dr. Dwight Smith pled guilty May 7 for their roles in a $13.8 million home care fraud and money laundering scheme, the Department of Justice says in a release. Four home health agencies that Yousafzai owned or helped operate, First Care Home Health Care, Moonlite Home Care Inc., Physicians Choice Home Health Care, and Quantum Home Care Inc., billed Medicare for services that were never provided, the feds say.

Yousafzai admitted to paying doctors, nurses, and other clinicians to create fictitious patient files and paying kickbacks to patient recruiters, the DOJ says. As a physical therapy assistant, he also falsified documentation himself.

"Today over 200 OIG Special Agents, Forensic Examiners and Analysts have deployed throughout the country to ensure that those responsible for committing Medicare fraud are held accountable," said HHS-OIG Deputy Inspector General Gary Cantrell in a May 2 statement.

To read the news release about the Strike Force's May 2 actions, visit www.justice.gov/opa/pr/2012/May/12-ag-568.html.