Medicare Fraud Strike Force Team

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Under the Office of Inspector General is the Medicare Fraud Strike Force Team. The Medicare Fraud Strike Force Team was created in 2007 and are currently operating in nine areas. With the help of Federal, State, and local law enforcements, the Strike Force team has shut down numerous health care fraud schemes, arrested over a thousand criminals, and has recovered millions of dollars (Office). On June 18, 2015 the Strike Force team led its largest takedown in history resulting in charges against 243 individuals that were involved in an approximate $712 million fraud scheme. Doctors, patient recruiters, home health care providers, pharmacy owners, nurses, and other licensed medical professionals all participated in this scheme. These defendants …show more content…
Under the Stark Law, physicians refer to chiropractors and dentists not nurse practitioners and physician assistants. An example of a violation of the Physician Self-Referral Law includes a provider referring a beneficiary for a certain health service to a business where the provider or immediate family member has an investment interest. A physician who does violate the Start Law will suffer consequences such as fines, repayment of claims, and exclusion from participating in all federal health care programs (Department, 2015 pg. 6; DiSantostefano, 2013 pg. 62). The Federal Claims Act, the Anti-Kickback Statute, and the Physician-Referral Law are designed to protect the federal government in different ways. These federal laws have not only protected the government, but have recovered millions of dollars from fraud crimes in the United …show more content…
259). By educating all employees of the health care industry about the serious consequences, this has the potential to eliminate and raise awareness about fraud. It can also make them think twice before violating the law. Education should be given annually to employees at all health organizations. New employees also should receive education on fraud and even the organizations regulations when first hired. The Patient Protection and Affordable Care Act has made it mandatory for all providers and suppliers who participate in Medicare and Medicaid to have a compliance program. Compliance programs make sure that the facility is obeying the rules and regulations. The goal of the compliance programs is to allow organizations to “police” their own actions by making them be more aware of their activities (Iglehart, 2015 pg. 1094). Having compliance programs mandatory for participating Medicare and Medicaid organizations has great potential to reduce fraud
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