Industry News

Medicare Fraud Strike Force Charges 91 Individuals for Criminal Activities for Falsely Billing Medicare for $430 Million

Lisa Shuman | October 2012

Attorney General Eric Holder recently commended the Medicare Fraud Strike Force for their action against 91 individuals in seven states who falsely billed Medicare for nearly $430 million. The resulting charges included anti-kickback violations, conspiracy to commit health care fraud, identity theft, money laundering, and wire fraud. The criminal activities spanned a variety of health care services, including ambulance services, durable medical equipment, home health care, mental health services, physical and occupational therapy, and psychotherapy. Additionally, the Department of Health and Human Services (HHS) suspended payments to 30 providers currently under investigation for fraud based on authority from the Patient Protection and Affordable Care Act.

According to Attorney General Holder, since its initiation in 2007, the Medicare Fraud Strike Force has charged approximately 1,500 individuals for fraudulently billing Medicare for over $4.8 billion. Further, for every dollar the Department of Justice and HHS have spent to stop health care fraud, seven dollars have been returned to the U.S. Treasury, the Medicare Trust Funds, and other agencies. The DOJ press release is available at: http://www.justice.gov/opa/pr/2012/October/12-ag-1205.html. The DOJ press release on Attorney General Eric Holder’s speech at the Health Care Fraud Takedown Conference is available at: http://www.justice.gov/iso/opa/ag/speeches/2012/ag-speech-1210042.html.


Department of Justice. “Medicare Fraud Strike Force Charges 91 Individuals for Approximately $430 Million in False Billing.” Press Release. 4 Oct. 2012. Department of Justice. “Attorney General Eric Holder Speaks at the Health Care Fraud Takedown Press Conference.” Press Release. 4 Oct. 2012.

About the Author

Ms. Shuman assists health care organizations to develop, implement and evaluate their compliance programs and HIPAA privacy programs. Ms. Shuman specializes in our firm’s HIPAA Privacy services, including leading privacy investigations, breach risk assessments, breach notification letters, breach reporting to the Office for Civil Rights and corrective actions plans. She specializes in serving as Interim Privacy Officer for large health care systems, managed care organizations, comprehensive cancer center and health care business associate.