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Catch of the Week -- Hundreds of Medical Professionals Charged in Healthcare Fraud Takedown

Posted  June 29, 2018

This week’s Department of Justice “Catch of the Week” goes to the hundreds of medical professionals charged in “the largest healthcare fraud takedown operation in American history.” The DOJ brought charges against 601 defendants for their alleged participation in schemes to bill Medicare, Medicaid, TRICARE, and private insurers for medications and treatments that were unnecessary and often never provided. Over a quarter of these defendants were charged for alleged involvement in prescribing and distributing opioids and other dangerous narcotics. The DOJ also alleged that co-conspirators received kickbacks for supplying beneficiary information to providers who used the information to submit fraudulent bills to Medicare. All told, the DOJ estimated over $2 billion in false billings arising from these frauds.See, e.g., DOJ Press Release.

According to the DOJ, this enforcement action – a coordinated effort between the DOJ, FBI, HHS, DEA, Department of Labor, IRS, thirty state Medicaid Fraud Control Units, and other state and federal agencies – is just the beginning. The DOJ has a new data analytics team, the Opioid Fraud and Abuse Detection Unit, designed to identify medical professionals associated with high volumes of drug prescriptions, dispensations, and patient overdoses. In addition, Attorney General Sessions has assigned a dozen prosecutors to focus exclusively on opioid and drug-related health care fraud. Describing opioid addiction as “the deadliest drug epidemic in the history of this country,” Attorney General Sessions affirmed the DOJ’s particular focus in this space:

[O]ur work is not finished. We are just getting started. We will continue to find, arrest, prosecute, convict, and incarcerate fraudsters and drug dealers wherever they are.

More than one HHS representative echoed the Attorney General on the importance combating drug-related health care fraud, which HHS Deputy Inspector General Cantrell described as “crimes that threaten the vitally important Medicare and Medicaid programs and the beneficiaries they serve.” Deputy Inspection Cantrell continued, “[t]hough we have made significant progress in our fight against health care fraud; our efforts are not complete. We will continue to work with our partners to protect the health and safety of millions of Americans.”

Tagged in: Catch of the Week, Healthcare Fraud,