"Today's coordinated actions represent one of the largest Medicare fraud takedowns in Department of Justice history, as measured by the amount of alleged fraudulent billings," Assistant Attorney General Lanny Breuer of the Justice Department's Criminal Division said in a statement.
In Dallas, 14 individuals were indicted for various fraud schemes totaling $103 million in false Medicare billings. One scheme run by a doctor and two nurses involved Raphem Medical Practice, owned by Dr. Joseph Megwa, and PTM Healthcare Services and allegedly led to about $100 million in fraudulent billings for home health services.
Megwa was accused of signing approximately 33,000 prescriptions for 2,000 different Medicare beneficiaries from 2006 to 2010. "In order to handle the volume of prescriptions, Megwa allegedly signed stacks of documents without reviewing them," according to a press release from the HHS.
In Houston, seven hospital administrators were indicted for paying kickbacks -- in the form of cigarettes and coupons to the hospital gift shop -- to Medicare patients in exchange for their attendance at the hospital's partial hospitalization program for mentally ill patients. Rather than receive the services the hospital billed Medicare, the government alleged, the patients watched television and played games, and administrators brought in $158 million through the scheme.
One participant, the assistant administrator of the hospital, Mohammad Khan, pleaded guilty in February to submitting fraudulent claims and paying kickbacks related to $116 million in false billings submitted to Medicare. Since Khan pleaded guilty, the department discovered an additional $42 million in fraudulent claims, which is included in today's total.
"We have made it one of the Department's missions to hold accountable those who abuse the Medicare program for personal profit," Breuer said in the statement. "And there are Medicare fraudsters in prisons across the country - some who will be there for decades - who can attest to our determination, and our effectiveness."
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