Hot line begun to take reports of waste, abuse of Medicare

October 07, 1997|By Michael James | Michael James,SUN STAFF

Saying that health care fraud is one of the nation's top two criminal problems, federal authorities announced a toll-free number yesterday that Marylanders can call to report waste and abuse affecting Medicare.

The "Health Care Fraud Hotline," 800-377-5879, was established because of staggering levels of Medicare fraud each year, said Lynne A. Battaglia, U.S. attorney for Baltimore. Health and human services officials estimate $23 billion is lost annually from the Medicare program.

Health care fraud is the No. 2 law enforcement priority for the U.S. Department of Justice, second only to violent crime, Battaglia said.

Medicare is particularly vulnerable to fraud schemes because the government processes more than 700 million Medicare claims annually and cannot scrutinize every claim. Prosecutors said that fact is well-known to unscrupulous health care providers who use it as a tool to defraud Medicare.

In Maryland alone, more than $20 million in civil and criminal fines have been imposed in fraud cases in recent years, prosecutors said.

Among recent cases:

Rockville physician John J. Merendino Sr. agreed in June to pay $3.1 million to resolve allegations that he improperly billed Medicare for physical therapy services provided to nursing home residents.

St. Joseph Medical Center in Towson agreed in May to pay $564,000 to resolve allegations that it improperly billed Medicare for ambulance-trip costs.

American Oxygen & Ambulance Service, a Baltimore ambulance company, agreed in April to pay $1.475 million to resolve allegations that it improperly billed the Medicare and Medicaid programs for ambulance trips to doctors' offices.

Pub Date: 10/07/97

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