Miami, FL – Federal authorities have arrested 12 people in South Florida as part of what the U.S. Department of Justice says is the largest coordinated health care fraud enforcement action in the nation’s history, targeting alleged schemes involving more than $6.5 billion in fraudulent health care claims.
The nationwide operation resulted in criminal charges against 455 defendants, including 90 physicians, nurse practitioners, pharmacists, and other licensed medical professionals.
Investigators allege the defendants participated in schemes involving false Medicare and Medicaid claims, illegal prescription drug distribution, and other forms of health care fraud.
According to federal prosecutors, authorities seized more than $27 million in Medicare payments connected to 12 South Florida clinics accused of allegedly submitting fraudulent claims for wound care and skin substitute treatments that were either medically unnecessary or never provided.
Among those charged in South Florida are a 57-year-old Hialeah woman accused of allegedly helping establish clinics that billed Medicare more than $117 million in fraudulent claims, a 58-year-old Miami man accused of allegedly operating a medical equipment fraud scheme involving approximately $3.76 billion in false claims, and a 53-year-old Texas physician accused of allegedly participating in an $89 million cardiovascular testing scheme.
Additional defendants include a 43-year old Miami man accused of allegedly submitting fraudulent disability certifications, a 36 year old Georgian national accused of allegedly laundering proceeds from a multibillion dollar health care fraud operation, and a 54 year old Miami man accused of allegedly participating in a mental health clinic fraud scheme.
Federal officials said the investigation remains ongoing.
All suspects are presumed innocent unless and until proven guilty in a court of law.