Published on February 2, 2014
Since March 2007, federal investigators have uncovered more than $5 billion in Medicare fraud, but they suspect that might just be the tip of the iceberg. As the prolific bank robber Willie Sutton reportedly said of robbing banks – because that’s where the money is – health care fraud has become a huge problem throughout the country. According to the U.S. Department of Justice, Georgia ranks 12th in investigations, seventh in the number of fraud cases and sixth in total recovered – almost $98.95 million in 2012. In the Southern District of Georgia, more than $27 million in restitution was collected last year in one of the country’s largest Medicare fraud prosecutions in 2005 – The Bio-Med Plus in Savannah. In Augusta, optometrist Jeffrey Sponseller was sentenced Jan. 9 to 33 months in prison and ordered to pay $441,000 in restitution for bilking Medicare. Federal investigations into Medicare fraud have exploded in response to the problem, said David Stewart, who recently left the U.S. attorney’s office where one of his duties was health care fraud coordinator. Medicare fraud affects everyone because Medicare has become the primary health care coverage for most Americans when they turn 65, said Kenneth Crowder, who recently left the U.S. attorney’s office and joined Stewart in private practice. When Medicare coverage started in 1966, 19.1 million were enrolled. In 2013, that number was 43.5 million, according to the Centers for Medicare and Medicaid Services.