Medicare fraud

In the United States, Medicare fraud is the collection of Medicare health care reimbursement under false pretenses. There are many different types of Medicare fraud, all of which have the same goal: to collect money from the Medicare program illegitimately.

The total amount of Medicare fraud is difficult to track, because not all fraud is detected and not all suspicious claims turn out to be fraudulent. According to the Office of Management and Budget, Medicare "improper payments" were $47.9 billion in 2010, but some of these payments later turned out to be valid. The Congressional Budget Office estimates that total Medicare spending was $528 billion in 2010.

The Medicare program is a target for fraud because it is based on the "honor system" of billing. It was originally set-up to help honest doctors who helped the needy with medical services.

Types of Medicare fraud

Medicare fraud is typically seen in the following ways:

2010 Medicaid fraud

The 2010 Medicaid fraud was a case of Medicaid fraud allegedly carried out by an Armenian-American organized crime group operating in the United States.

The crackdown

In a scandal involving a case to defraud the Medicaid and other healthcare programs such as Medicare, providing health care to senior citizens and elderly, in an amount totalling $163 million, more than 50 ethnic Armenians living in the United States were arrested on October 13, 2010. The operation was run by more than 400 FBI agents. In addition to FBI, IRS and local enforcement agencies in California, Georgia, New Mexico, New York and Ohio were involved in the probe. The Justice Department has already indicted 73 individuals in New York and four other states. 44 defendants were indicted in New York, along with 10 in California, seven in New Mexico, six in Ohio and six in Georgia. According to the authorities, the Armenian-American organized crime group operated across 25 states.

Leadership and members of the organization