114 Charged in Biggest Medicare Scam Takedown in U.S. History

A health care crime sweep on Thursday revealed that 114 people took part in what could be the largest Medicare scam takedown in U.S. history. The sweep of nine metropolitan areas found that that at least 40 schemes were in play and, as a result, the government was being defrauded of over $240 million.

Plots Involved Doctors and Health Practitioners

An announcement made by Attorney General Eric Holer revealed that the over 40 schemes were mostly being conducted by doctors and health practitioners, the majority of whom were acting along.

After sweeping nine metropolitan areas, which included Los Angeles, Brooklyn, Miami and Detroit, law enforcement discovered that many of these medical professionals were billing for services that didn’t exist.

Among the highest-profile defendants being charged is Aleksandr Kharkover, a Brooklyn physical therapist who is being charged in at least one of three separate rings. So far, he is being charged for billing Medicare about $11.9 million from Jan. 2005 to July 2010 for physical-therapy services that either were never performed or weren’t medically necessary.

Other defendants charged include:

  • Ollie Futrell: Charged with bribing Medicare patients to say they received home-health services they never received and even asking them to bring new patients into the scheme.
  • Errol Sherman: Podiatrist charged with billing Medicare for toenail removals that never happened.
  • Boris Sachakov: Proctologist charged with “unbundling,” which means to break a group of charges into many single charges, an act that makes more money but is against the law.
  • Justina Amuche Okehie: Chiropractor charged with five others for physical therapy scams, which resulted in billing both Medicare and Medicaid $4.7 million from Jan. 2007 through Aug. 2010.

Despite the high number fraud rings being brought to light, FBI Executive Assistant Director Shawn Henry said more are out there. Because they are so profitable and easy to organize, health professionals often can’t resist the temptation to participate.

Why Medicare and Medicaid Scams are Problematic

In 2009, Senate members announced their decision to crack down on Medicare and Medicaid fraud as a way to fund health care in the coming years. As seen by this sweep of health insurance fraud cases, it’s easy to see why.

The hundreds of millions of dollars being lost to scams are overwhelming the budget. In other words, this scamming problem leaves less money available to provide real services to those in need.

As mentioned, the ease of filing a claim makes fraud an almost certainty for those who attempt it. As the process goes, each claim filed must be paid in 14 to 30 days. With each system receiving millions of claims each day, only 3 percent are actually reviewed, which means plenty of scams can slip through the cracks.

Lawmakers hope this crackdown can result in more scammers being caught. The more money that is spared from both of these systems, the more will be available for recipients in both programs.htt