At least 16 people in Texas were arrested following an investigation involving the FBI and multiple other agencies. Their charges involve allegations of health care fraud. The suspected cases of fraudulent health care claims include employees at least one clinic that provided rehabilitation and therapy services to children.
Workers at the children’s clinic have been accused of filing falsified claims of service to Medicaid. In addition to claiming that patients received services that may not have actually been provided, other patients might have been overbilled for the therapeutic services they received. It is unclear what authorities suspect might have happened with the alleged fraudulent payments.
An agency that provided home health assistance to patients is also involved in the ongoing investigation. Medicaid believes that some time sheets that it received were falsified, and that the defendants were attempting to receive compensation for certain services that might not have ever taken place. Additionally, at least one person has been accused of receiving compensation for encouraging patients to use the agency.
Aside from the individuals who were arrested in Texas, hundreds of other people across the United States now face charges for allegedly engaging in health care fraud. Although the FBIs involvement might worry the defendants, a regional representative conceded that it would likely be difficult to actually prove that the fraud took place. However, defendants should still take care to construct the most solid foundation for their defense strategy alongside their counsel. Doing so in a timely manner can help those facing these types of fraudulent or white-collar crimes determine how to proceed in a manner that will garner the most favorable outcome possible.
Source: krgv.com, “Largest National Medicare Fraud Takedown”, June 18, 2015