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42
Healthcare Journal of BATON ROUGE  
MAY / JUN 2012
f i ght i ng fraud
Back in 2010, the US Department of
Health and Human Services, Office of the
Inspector General created a
HEAT Strike
Force
to target an excessive number
of fraudulent Medicare claims in Baton
Rouge. The Strike Force recently released
this impact chart, which dramatically
illustrates the effect that local agents and
their partners have had in reducing the
amount of fraudulent claims in the area.
The
HEAT
is On...
The chart reflects
the amount paid for wheelchair and orthotic claims
broken down by yearly quarters. According to William W. Root, Assistant
Special Agent in Charge, USDHHS/OIG, the peak in the fourth quarter of
2008 represents over $3 million being paid in orthotic claims and $2.25 mil-
lion in wheelchair claims. This time frame can be associated with the Durable
Medical Equipment (DME) companies directly involved with Mr. Henry L.
Jones, said Root. Mr. Jones was convicted in two separate jury trials in 2011
and pleaded guilty to healthcare fraud in early 2012 to avoid a third trial. OIG
records indicate that Mr. Jones may be responsible for over $13.5million paid
by Medicare for illegal DME claims in the Baton Rouge area.
The sharp decline represents the aggressive investigative effort by the Baton
Rouge office and the FBI in late 2008 and early 2009. Even though the offi-
cial start date of the HEAT Strike Force was in February 2010, investigations
of Mr. Jones and his associates had begun a few
years earlier. The second sharp decline in 2010
follows the first Strike Force Takedown date in
July 2010 when the agency indicted 28 individ-
uals of Medicare fraud.
Currently OIG records indicate that 48 subjects
have been indicted and 34 have either been
convicted or pleaded guilty to Medicare fraud.
The Strike Force currently has over 20 Medi-
care providers under investigation. The HHS
OIG believes that the total loss to Medicare
caused by the providers under investigation by
the HEAT Strike Force in Baton Rouge exceeds
$300 million.
Baton Rouge Strike Force Impact