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FBI agents used a dummy home health agency to break up a Miami crime ring that allegedly bilked Medicare of more than $10 million. Indictments were leveled against seven doctors, 12 registered nurses, and 20 other people.
The arrests came as part of Operation Medweb, a three-year FBI undercover investigation of health fraud. The investigation initially involved the FBI buying and running a small non-certified home health agency (HHA), ironically called Perfect Nursing, that solicited business from local doctors and recruiters. Several doctors agreed to sign false home health certifications in return for cash or a chance to bill Medicare for office visits and unnecessary tests, according to the Justice Department.
The investigation later broadened its focus to include Amitan, a Miami HHA whose owners used Perfect Nursing and other subcontractors. The subcontractors had pools of patients for which they submitted phony claims to Amitan, which in turn billed Medicare for skilled nursing benefits, according to prosecutors.
FBI Director Louis Freeh warns that the bureau "is making far greater use of undercover investigations to crack down on large-scale health care fraud." The number of agents dedicated to fighting health care fraud has soared from 112 in 1992 to 356 in 1997, according to Freeh.