FBI Houston and the Houston-Area Medicare Fraud Strike Force (MFSF) arrested twelve individuals, including two health care professionals, for their alleged participation in health care fraud schemes. The arrests were the result of a nationwide Medicare fraud takedown— the largest healthcare fraud enforcement action in American history.
The local Houston arrests were achieved through the efforts of personnel from multiple law enforcement partners, including the Department of Justice, the Federal Bureau of Investigation, the Department of Health and Human Services (HHS) Office of the Inspector General (OIG), the Texas Office of the Attorney General- Medicaid Fraud Control Unit (MFCU), the United States Attorney’s Office of the Southern District of Texas, and the Internal Revenue Service (IRS) Criminal Investigative Division. Law enforcement aggressively targeted the most egregious schemes involving the billing of Medicare and Medicaid and private insurance programs for medically unnecessary services and compound prescription drugs, as well as violations of illegal kickbacks.
“These individuals rob this nation of its precious taxpayer dollars,” said FBI Special Agent in Charge (SAC) Perrye K. Turner. “Some Houston-area medical professionals, including doctors, nurses and pharmacological representatives, have chosen to break the law and place their greed before those whom they are charged to heal. Health care fraud investigations, involving both public and private insurance programs, are considered a high priority throughout the FBI. The FBI and our partners will continue to target and hold accountable those who defraud the system.”
Twenty-nine state Medicaid Fraud Control Units also participated in this week’s national arrests. “These arrests are a testament to the effectiveness of collaborative law enforcement work to crack down on those who defraud Texas taxpayers. Texas Attorney General Ken Paxton is committed to continuing to work with our federal partners to uncover waste, fraud, and abuse in the Medicare and Medicaid systems,” said Stormy Kelly, Division Chief within the Medicaid Fraud Control Unit of the Office of Texas Attorney General.
The Department of Health and Human Services announced today that from July 2017 to the present, it has excluded 2,700 individuals from participation in Medicare, Medicaid, and all other Federal health care programs, which include 587 providers for their conduct related to opioid diversion and abuse. “This takedown is a warning to fraudsters that their crimes will be uncovered,” said C.J. Porter, Special Agent in Charge for the U.S. Department of Health & Human Services Office of Inspector General. “Along with our law enforcement partners, we will work to ensure that criminals who orchestrate these schemes are brought to justice.”
The national takedown targeted over 590 charged defendants across 56 federal districts, including more than 150 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $2 billion in false billings. “Health care fraud is a betrayal of vulnerable patients, and often it is theft from the taxpayer,” said Attorney General Sessions. “In many cases, doctors, nurses, and pharmacists take advantage of people suffering from drug addiction in order to line their pockets. These are despicable crimes.”
The FBI encourages anyone with any information regarding health care fraud to contact the Medicare hotline at 1-800-MEDICARE (1-800-633-4227), or tips may be submitted through the FBI tips website at https://tips.fbi.gov.