A joint federal task force arrested more than 90 doctors and medical personnel in Los Angeles and across the country and on Tuesday unsealed allegations that they conspired to commit $260 million in Medicare fraud through bogus billings.
“The fraud was rampant, it was brazen and it permeated every part of the Medicaid system,” according to Acting Assistant Attorney General O’Neil.
Eight people were charged in Los Angeles with scheming to falsely extract $32 million from the government, with $24 million of that attributed to a single doctor. Dr. Robert A. Glazer (pdf), who has a clinic on Santa Monica Boulevard in Hollywood, was alleged to have raked in the money by submitting claims for, among other things, 1,000 expensive electric wheelchairs and 30,160 allergen injections since 2006.
The legal complaint said Dr. Glazer received kickbacks for the wheelchairs, which were “not medically necessary,” and that no one ever saw the doctor or anyone else at the clinic actually give a patient an allergen injection. Nearly 15% of the doctor's billings were for the injections that 345 beneficiaries allegedly received. The injection was described as an “uncommon procedure that should only be used in specific circumstances.”
Glazer also allegedly prescribed home health care of eight to 10 weeks, sometimes without a patient's knowledge or against their express wishes, and often for services that were scantily provided if provided at all. The complaint says 15 of the 17 beneficiaries cited in the DOJ affidavit did not receive any services.
Glazer's alleged escapades pale by comparison to Brooklyn physician Syed Imran (pdf), who was accused of fraudulently billing Medicare for $85 million from January 2011 to December 2013 and collecting $7.3 million. His modus operandi was said to involve surgeries that never happened. He was arrested last month.
Most of the indictments, 57, were in Miami and Tampa, Florida. The charges display a wide variety of fraud schemes including medical treatments and services such as home health care, mental health services, psychotherapy, physical and occupational therapy, durable medical equipment and pharmacy fraud. In many cases, the scams included the use of patient recruiters, Medicare recipients and co-conspirators for construction of fraudulent bills to the government.
This is the seventh operation by the strike force since its creation in 2007. So far, 1,900 defendants have been accused of Medicare fraud to the tune of $6 billion. More than 17,000 providers have been removed from Medicare rolls since 2011, the DOJ said.
Last month, the government released Medicare data long sought by critics of the program which showed $15 billion of the the $77 billion paid out in 2012 (24%) went to just 2% of practitioners.