Fake Medicaid claims for children’s therapy results in Medicaid fraud arrests

 

A rehabilitation clinic and its owners have been accused of faking Medicaid claims for children’s therapy services that were never rendered. One employee was a woman who was unlicensed called herself a doctor and she has been charged with illegally diagnosing patients and prescribing drugs billed to Medicare. Authorities listed 16 arrests Thursday in six cases targeting purported false billings, kickbacks and theft involving healthcare providers across South Texas — part of a nationwide crackdown targeting federal insurance fraud.

The six cases, billed as the “South Texas Health Care Fraud Takedown,” represented $7 million in federal insurance payments that prosecutors said resulted from false billings and kickbacks by healthcare providers across the region. Also charged is a mission home healthcare provider accused of receiving more than $3.5 million in fraudulent Medicare reimbursements for adult diapers not delivered or only partially delivered to patients.

With its widespread elderly and low-income population, Hidalgo County’s home healthcare industry in Texas has boomed.

Between January and May, more than $100 million has been billed to the government insurance programs in Hidalgo County alone — most of which was likely fraudulent, says Government authorities.

But with federal insurance programs that officials said receive as much as $1 billion in billings across the country every day, fraud is inevitable — a truth since the government created Medicare in the 1960s, Magidson said.

That doesn’t mean investigators won’t catch up and target those bilking the government, said Christopher Combs, special agent in charge for the FBI’s San Antonio Field Division, which includes the Rio Grande Valley.

Jeffrey Newman represents whistleblowers