Dallas ring, Houston chiropractor caught up in Medicare fraud bust

giving a shot

A Dallas ring that billed Medicare for more than $1 million while bribing and paying kickbacks to patients for unnecessary medical services in their homes was broken in the largest Medicare fraud sweep in U.S. history, according to Attorney General Eric Holder.
The federal government charged 114 people in nine cities including Dallas, Miami, Los Angeles, Brooklyn and Detroit and Miami with attempting to defraud Medicare of $240 million through dozens of unrelated schemes, the Wall Street Journal is reporting today
 The defendants include Houston chiropractor Justina Amuche Okehie, who together with five others was charged for fraudulent billing in an alleged physical therapy scam. Okehie’s lawyer said his client had pleaded not guilty.
The sweep stemmed, in part, from a series of stories the Journal has written over the past six months outlining the breadth of fraud in the federal health care system. Dow Jones & Co., publisher of the Journal, has filed suit to overturn a 1979 privacy rights ruling that prohibits the public, which pays the bill for Medicare, from examining the billing records of individual doctors.

Dow Jones is arguing that making Medicare billing records public would enable anyone - citizens, journalists, state medical boards, nonprofit watchdog groups - to monitor the troubled $500 billion Medicare program.

The Medicare Fraud Strike Force of FBI agents, officials with the Department of Health and Human Services Inspector General’s office and  U.S. attorneys with the Department of Justice mobilized more than 700 federal, state and local agents for the sting, Holder said.

Health and Human Services Secretary Kathleen Sebelius applauded the prosecution, but said the federal government needed to do a better job of controlling the funding before it is misused.

"The fact that you can have an operation this large with cases that aren't connected shows the extent of the problem," an unnamed senior investigator told the Journal. Medicare fraud is "so rampant, there's no way in hell you can prosecute your way out of this problem, no way. The answer is not prosecution—the answer is more effective monitoring of the money that goes out."
Contact Mark Lisheron at 512-299-2318 or mark@texaswatchdog.org.

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Photo of someone giving a shot by flickr user blakespot, used via a Creative Commons license.