Medicare yanks licenses in Detroit and other cities, gives them right back

Oct 17, 2011

A review conducted by the Associated press found that regulators working to eliminate Medicare fraud (estimated at between $60-90 billion a year) often suspend Medicare provider licenses only to reinstate them in short order following appeals hearings.

More from the Associated Press:

The review also found government officials don't attend the hearings.

Federal prosecutors say the speedy reinstatements are a missed chance to stop taxpayer dollars from going to bogus companies that in many cases wind up under indictment. Prosecutors say some providers have collected tens of thousands of dollars even after conviction.

Officials revoked the licenses of 3,702 medical equipment companies in fraud hot spots in South Florida, Los Angeles, Baton Rouge, La., Houston, Brooklyn, N.Y., and Detroit between 2006 and 2009. About 37 percent were reinstated.

Last month, Michigan Radio's Sarah Cwiek reported on slew of Medicare fraud charges filed against Detroit-area providers:

Federal prosecutors in Detroit have charged another 28 people in three alleged Medicare fraud schemes.

The allegations outline typical Medicare fraud schemes totaling over 28-million dollars.

One scheme involved 14 people operating out of the Detroit suburb of Livonia, who allegedly submitted fraudulent claims for home health care services.

Detroit is one of nine U.S. cities with a dedicated Medicare Fraud Strike Force.  U.S. Attorney Barbara McQuade says health care providers can commit Medicare fraud by preying on the most vulnerable.

“We have a lot of who are out of work, and we have people who are willing to provide their private information to providers in exchange for cash,” McQuade says.

Detroit’s Strike Force has charged 138 people with Medicare fraud since its inception in 2009. 

- John Klein Wilson - Michigan Radio Newsroom