Texas case another example of rampant Medicare fraud

(Dallas, Tex.)—Irene Anderson, 45, owner of a home health care agency in Wylie, Texas, has pled guilty to mail fraud. Anderson created a fictional identity in order to defraud Medicare. Anderson set up a second healthcare agency in Sulphur Springs, which garnered $1,188,698, under the fictional name “Ilya Edwards.”  She obtained a social security number and a Texas driver’s license for that name too, falsely representing herself.  The Dept. of Justice says the woman faces a maximum statutory sentence of 20 years in prison and a $250,000 fine. She has agreed to restitution of more than $2 million. This is one small example of rampant fraud in federal health programs. In states like Florida, state government officers are going after people who defraud Medicare.

The Texas investigation involved the US Dept. of Health and Human Services, Office of Inspector General, Immigrations and Customs and the FBI. During a 3-month period in 2007, HHS-targeted efforts against individuals and health care companies that fraudulently bill the Medicare program yielded 56 arrests and stopped companies who collectively billed more than $258 million to Medicare.

HHS has also announced several demonstration projects focused on preventing deceptive companies from operating in South Florida, Southern California and the Houston area.

In March, Florida Attorney General Bill McCollum issued remarks about fraud in the 4th largest state in the nation: “Recent reports show as much as $2 billion a year may be lost in Florida’s $16 billion Medicaid program to fraud and abuse. Last year, the Medicaid Fraud Control Unit investigated 1,013 complaints and returned approximately $70 million in defrauded funds to the state.”