WATCH: Feds: Health care fraud costs you billions

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by By Jeff McShan / 11 News

kvue.com

Posted on August 15, 2009 at 4:38 PM

Updated Tuesday, Oct 20 at 3:08 PM

KEMEH, Texas -- Inside a Kemah home, located on the shores of Clear Lake, federal investigators say they found more than $800,000 in cash.

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Feds: Health care fraud costs you billions
July 1, 2009

They say that they found another $750,000 in two safe deposit boxes.

The $1.5 million in mostly $20 bills allegedly belonged to Dr. Arun Sharma and his wife Dr. Kiran Sharma.

The doctors were charged with health care fraud and are now out on bond.

The FBI says that the amount of health care money stolen each year in this country is staggering.

They say that in 2007, Americans spent $2.24 trillion on health care. They estimate that up to 10 percent or $224 billion was lost due to fraud.

In Houston and around the country, joint task forces led by the FBI are targeting this type of criminal activity.

Federal, state, and local agencies worked together to check out claims of alleged "pill mill clinics" in Webster and Baytown.

Indictments were handed down in that case. Those documents state that the Sharma's were seeing more than 70 patients a day, that they were prescribing narcotics to people who were profoundly addicted to drugs and they were allegedly threatening those individuals.

Authorities say that the Sharma's wouldn't give out prescriptions to patients unless they would fill out visit sheets which claimed they had visited the clinic on certain days even though they had not.

Investigators say that the fraudulent sheets allowed the Sharma's to bill Medicare and Medicaid $8.7 million for injections that were never performed.

The indictment also states that the Sharms's charged patients up to $100 in cash to get a prescriptions.

The federal government is taking steps to seize the Sharma's home in Kemah which is allegedly purchased with your tax dollars.

FBI officials say they can't comment on the Sharma case because it is still ongoing, but Special Agent Elvis McBride did say that health care fraud investigations like this one are paper intensive and take a lot of time.

"It takes time because a lot of times you have to request data from Medicare to see what the provider billed who they billed. You actually have to go out and talk with some of the Medicare beneficiaries," said McBride.

Agent McBride insists the government is beefing up enforcement here in Houston around the country to fight this type of crime and he says everyone else can help too.

"I think you should treat your Medicare, Medicaid card as if it were your credit card. Because once they get your information they will pretty much bill just to dupe the system," said McBride.

Locally, the task force is currently investigating nearly 100 cases.

One of the biggest probes involves Dyain and Tajuana Frazier.

The Fraziers have already been charged and are schedule to be in court next week.

The district attorney's office says that the Fraziers, along with 11 other suspects, stole $6.1 million through illegal billing. More arrests are expected. Despite the charges, the Fraziers claim they are innocent.

The attorney general's office says all suspects in this case billed the Texas Medicaid program for adult diapers, wheelchairs, and other medical supplies that were never delivered.

Anyone with information on health care fraud is urged to call the FBI Houston at (713) 693-5000.

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