Case Study

USA, July 2016 – Justice Department Charges Three in $1 Billion Medicare Fraud Scheme in Florida

A network of hospitals and healthcare providers in South Florida are under investigation for alleged improper billing to Medicare and Medicaid, two government programmes to help cover healthcare costs, to a sum of more than US$1 billion.

The Justice Department alleges that bribes and kickbacks were paid to get thousands of patients admitted to skilled-nursing and assisted-living facilities. At these facilities patients were given unnecessary treatments that were charged to the government programmes. The defendant is accused of also receiving bribes and kickbacks from other health providers to refer patients, with some payments disguised as charitable donations.

Attorneys for the defendant deny the allegations.

http://www.wsj.com/articles/justice-department-charges-three-in-1-billion-medicare-fraud-scheme-in-south-florida-1469218807

The Pharmaceuticals & Healthcare Programme is an international programme of Transparency International, based in the London office of Transparency International UK.

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