US Agents Smash Billion-Dollar Health Care Fraud Scheme

U.S. federal agents have smashed a worldwide medical care scheme that defrauded U.S. taxpayers of more than $1 billion.

The Justice Department said Tuesday 24 people have been charged, including doctors, telemarketers and the heads of companies that provide back, wrist and knee braces.

“This Department of Justice will not tolerate medical professionals and executives who look to line their pockets by cheating our health care programs,” U.S. Assistant Attorney General Brian Benczkowski said Tuesday.

The extensive and complex scheme stretched from the U.S. to call centers in the Philippines and across Latin America.

Telemarketers would phone patients offering them free medical braces. When call centers verified that the patients were covered by Medicare, they were transferred to telemedicine companies, where doctors — who never examined the patients — would prescribe the braces even if there was no medical reason to have one.

The medical equipment companies would bill the government and kickback a portion of the funds to the others in the scam.

The fraud was detected last year when a number of Medicare beneficiaries smelled what sounded like a scam and called a government hotline.

The FBI, Health and Human Services, and Internal Revenue Service investigated.

“The breadth of this nationwide conspiracy should be frightening to all who rely on some form of health care,” IRS investigations chief Don Fort said. “The conspiracy … details broad corruption, massive amounts of greed and systemic flaws in our health care system that were exploited by the defendants.”
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