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/

Advertisements

‘Deadly mess’: Ohio sues five pharma companies over opioid crisis


Ed. Note: Someone needs to do an expose` on methadone clinics.

Do the math, at an ave. cost of $300-$500 a month for each patient – they are BIG BUSINESS for pharmaceutical companies. Most clinics have hundred’s, if not thousands of patients scheduled for daily doses. 

For most patients addicted to opioid medications, methadone treatment becomes the only way to escape addiction or death. But, ultimately they’re trading one addiction for another one. It’s an endless, deadly cycle since only 2% of patients successfully detox from methadone, to lead a drug free life…food for thought. 

Blessings {~A~}

RT

© GLobal Look Press

Ohio is suing five drug manufacturers for their role in causing the state’s unprecedented addictions crisis, and accusing them of intentionally misleading patients about the dangers of painkillers and claiming drug benefits not backed by science.

State Attorney General Mike DeWine, who announced the lawsuit on Wednesday, said the state was awash in opioids and engulfed in a public health crisis. DeWine said the drug companies had created a “deadly mess in Ohio that they now need to pay to clean up.”

The five companies being sued were Purdue Pharma LP, Johnson & Johnson’s Janssen Pharmaceuticals Inc unit, a unit of Endo International Plc, Teva Pharmaceutical Industries Ltd’s Cephalon unit and Allergan Plc.

The lawsuit claims that brand-name drugs such as OxyContin and Percocet and generics such as oxycodone and hydrodone are powerful narcotic painkillers that historically “were considered too addictive and debilitating for the treatment of chronic pain (like back pain, migraines and arthritis),” and were only to treat “short-term acute pain or for palliative (end of life) care.”

“[B]y the late 1990s, and continuing today, each Defendant began a marketing scheme designed to persuade doctors and patients that opioids can and should be used for chronic pain, a far broader group of patients much more likely to become addicted and suffer other adverse effects from the long-term use of opioids,” the lawsuit states.

The complaint claims that the total number of opioid doses prescribed to Ohio patients in 2012 soared to 793 million.

“[E]nough to supply every man, woman and child in the state with 68 pills each. In 2016 alone, 2.3 million Ohio patients – roughly 20 percent of the state’s population – were prescribed an opioid drug,” stated the complaint. “There are an estimated 1.2 million Ohio citizens suffering from chronic pain,” it added.

“This lawsuit is about justice, it’s about fairness, it’s about what is right,” DeWine said in announcing the suit, which was filed in civil court in Ross County.

DeWine argued the state saw a 36 percent increase in unintentional fatal overdoses in 2016 from the previous year, when the state led the nation for the most fatal overdoses.

Drug-related overdoses surpassed car accidents as the leading cause of accidental death in the state in 2017.

“We believe the evidence will [show] … these drug manufacturers led prescribers to believe that opioids were not addictive, that addiction was an easy thing to overcome, or that addiction could actually be treated by taking even more opioids,” said DeWine during a livestreamed press conference. “They knew they were wrong, but they did it anyway – and they continue to do it.”

The defendant companies are accused of spending millions of dollars on promotional activities that “trivialized the risks of opioids while overstating the benefits of using them for chronic pain,” and borrowing a page from Big Tobacco’s playbook by enlisting third parties to present guidelines that mislead doctors and patients.

The defendants are accused of creating a financial burden on the state, increasing costs for Medicaid and Bureau of Workers’ Compensation and additional costs for addiction treatment and treatment of babies born addicted to opioids.

They are also accused of violating Ohio Consumer Sales Practices Act and creating a public nuisance by disseminating false and misleading statements about the risks and benefits of opioids.

The lawsuit seeks a declaration that the companies’ actions were illegal, an injunction to stop their continued deceptions and to stop the harm they have caused, damages for the money the state spent and repayments to consumers for unnecessary opioid prescriptions for chronic pain.

Opioids are now the most prescribed class of drugs and generated $11 billion in revenue for drug companies in 2014 alone, according to the complaint.

A growing number of state and local governments are suing drug makers and distributors, seeking to hold them accountable for the opioid crisis.

In 2015, Kentucky settled a similar lawsuit with Purdue Pharma. The company agreed to pay the state $24 million in a lawsuit that accused the company of misleading the public about the addictiveness of the prescription drug OxyContin.

Comment: For more on the opioid epidemic:

%d bloggers like this: