DOJ announces largest healthcare fraud bust in nation’s history


Thursday morning, Attorney General Jeff Sessions and Department of Health and Human Services Secretary Tom Price, M.D., announced at a press conference the conclusion of a massive takedown operation by the Medicare Fraud Strike Force, involving $1.3 billion in fraudulent Medicare and Medicaid billings.

The takedown is being described as the largest in the history of the Department of Justice, with charges being brought against 412 defendants across the nation, including 115 doctors, nurses and other licensed medical personnel, according to a DOJ press release.

As a result of the investigation, the HHS department has suspended or banned 295 health care providers from participating in federal healthcare programs.

Also speaking at the press conference, HHS Inspector General Daniel Levinson confirmed this is the nation’s largest criminal healthcare fraud takedown in history, which required the expertise and coordination of over 1,000 federal state and local law enforcement, including nearly 350 agents from the office of Inspector General.

Arrests occurred Thursday in 41 federal districts, assisted by 30 state Medicaid Fraud Control Units.

“Over 120  defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics,” the DOJ reported.

Charges were filed for fraudulent billing schemes targeting Medicare, Medicaid and TRICARE (a health insurance program for military members and veterans) for medically unnecessary and false drug prescriptions, including the illegal distribution of opioids.

According to the Department of Justice, arrests include the following:

  • Southern District of Florida – 77 defendants were charged in fraud schemes involving over $141 million in false billings for home health care, mental health services and pharmacy fraud.
  • Eastern District of Michigan – 32 defendants were charged for $218 million in false claims, including fraud, kickbacks, money laundering and drug diversion schemes.
  • Southern District of Texas – 26 individuals were charged for over $66 million in Medicare and prescription fraud.
  • Central District of California – 17 defendants were charged for $147 million of Medicare fraud schemes.
  • Northern District of Illinois – 15 individuals were charged for $12.7 million in fraudulent billing.
  • Middle District of Florida – 15 individuals were charged, involving over $12.7 million in fraudulent billing.
  • Eastern District of New York – 10 individuals were charged for $151 million worth of fraudulent Medicare and Medicaid billings.
  • Louisiana and Mississippi – 7 individuals were charged in connection with over $207 million in fraudulent billing.
  • To see the complete list, visit the press release on the Justice Department website.

Attorney General Jeff Sessions, in his remarks, expounded on just some of the schemes that were taken down:

One fake rehab facility for drug addicts in Palm Beach is alleged to have recruited addicts with gift cards, visits to strip clubs, and even drugs-enabling the company to bill for over $58 million in false treatments and tests.

Another illegal clinic in Houston allegedly gave out prescriptions for cash. Just one doctor at this clinic allegedly gave out 12,000 opioid prescriptions for over 2 million illegal painkiller doses. These defendants have been charged and they will face justice.

He spoke of the dangerous drug and opioid epidemic in America today. “One American dies of a drug overdose every 11 minutes and more than 2 million Americans are ensnared in addiction to prescription painkillers.”

“We are sending a clear message to criminals across the country: we will find you. We will bring you to justice. And, you will pay a very high price for what you have done,” Sessions said.

“Healthcare fraud is not only a criminal act that costs billions of taxpayer dollars – it is an affront to all Americans who rely on our national healthcare programs for access to critical healthcare services and a violation of trust,” said Secretary Price. “The United States is home to the world’s best medical professionals, but their ability to provide affordable, high-quality care to their patients is jeopardized every time a criminal commits healthcare fraud. That is why this Administration is committed to bringing these criminals to justice, as President Trump demonstrated in his 2017 budget request calling for a new $70 million investment in the Health Care Fraud and Abuse Control Program. The historic results of this year’s national takedown represent significant progress toward protecting the integrity and sustainability of Medicare and Medicaid, which we will continue to build upon in the years to come.”

http://dennismichaellynch.com/doj-announces-largest-healthcare-fraud-bust-nations-history/

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