Two people have been arrested and charged with fraudulently billing insurance companies for more than $600,000 in services that were never provided. Gevorg Melkonyan and Elina Aruryunova are accused of stealing nearly 130 identities from Medicare recipients and 12 doctors to generate phony Medicare reimbursement claims.
The Department of Insurance became involved when one of the physicians whose identity was stolen contacted them to report that patients he had never treated were calling about charges from his office that showed up on their insurance statements. Further investigation led the Department to the fraudulent claimants.
The Obama administration recently awarded $9 million in grants to help more than 50 organizations combat Medicare fraud. Much of the money will be spent on information and education programs designed to teach Medicare recipients how to spot and report potential Medicare fraud. The grants, which fund the Senior Medicare Patrol (SMP) are targeted to assist in areas where Medicare fraud is among the highest. To date, the program has reached more than 3 million Medicare recipients and has produced more than 3,000 reports of Medicare fraud, waste and abuse.
Medicare fraud is a growing problem. The National Health Care Anti-Fraud Association estimates that about 3% of total expenditures on health care are based on fraudulent claims. If the statistic is accurate, that means about $15 billion is wasted each year on fraudulent Medicare claims.
In October, the FBI launched raids that resulted in the arrests of 73 Armenians with ties to organized crime after finding billing for $163 million from nearly 120 non-existent clinics in 25 states. In this particular fraud ring, the organizers used identity information stolen from nearly 3,000 New York Medicare recipients to generate bills for services. About $36 million was paid since the operation began in 2006. Phony invoices for unreasonable tests performed by specialists tipped investigators to the fraudulent scheme.