U.S. Charges 11 in Russia-Based Scheme to Bilk Medicare of $10.6 Billion

New York Times

12 hours ago

When hundreds of thousands of Medicare recipients were billed for expensive medical equipment they never asked for in 2023, doctors and health care providers around the United States feared a far-reaching fraud.
Those fears were well-founded, federal prosecutors say.
The surge in Medicare claims, for urinary catheters, braces and other durable medical equipment, was part of one the largest schemes ever designed to defraud the program, according to an indictment unsealed in the Eastern District of New York this week.
The indictment charges 11 citizens of the United States, Estonia and the Czech Republic with working for a criminal organization based in Russia that, prosecutors say, defrauded Medicare of $10.6 billion.
The scheme involved buying dozens of companies that were accredited to submit claims to Medicare and the program's supplemental insurers, prosecutors say.
Then, using personal information stolen from more than a million Americans, the defendants filed billions of dollars in claims for equipment that had not been ordered by Medicare beneficiaries and was not delivered to them, according to the indictment.
Even if the patients themselves did not pay for the phantom medical supplies, such schemes can affect Medicare recipients by causing premium costs to rise.
Want all of The Times? Subscribe.