20 plus arrested in largest DC health care fraud

WASHINGTON (WUSA9) -- The FBI arrested more than 20 people Thursday in what they are calling the largest health care fraud takedown in the District's history.

The schemes involved fraud, kickbacks and false billings. Medicaid allows qualified beneficiaries to have aides come to their homes and help them bathe, dress, eat, take medicine, etc. These alleged fraudsters capitalized on this.

One scheme involved recruiters teaming up with beneficiaries to bilk the system of millions of dollars. The FBI says the recruiters would coach the beneficiaries, sometimes with doctors' help, to show them how to fake or exaggerate their symptoms so they would qualify for home health care aides. Then, they would sign time sheets for aides who would never show up, saying they did.

The aides would then report back to their agency, who would then file false claims with Medicaid to the tune of millions of dollars. The beneficiaries would get up to $200 a week to lie.

Another related scheme involved one woman accused of selling counterfeit home health care aide certificates.

One tip-off was the 300% growth of the number of beneficiaries qualifying for home health care aides in the last seven years.

United States Attorney for the District of Columbia Ronald Machen says the FBI has been working on this takedown for years. "This fraud diverts previous taxpayer dollars, drives up the cost of health care, and jeopardizes the strength of a program that serves the most vulnerable members of our society."

Starting Thursday, the FBI is rolling out electronic ads in bus shelters throughout the District displaying their healthcare fraud hotline, 1-855-281-1242


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