DOJ charges 601 people for alleged health care fraud

Lynette PayneJul 01, 2018

The Department of Justice on Thursday announced charges against 601 people allegedly responsible for $2 billion in health care fraud, including 65 doctors, nurses and other licensed medical professionals.

Already, Sessions said, enforcement has resulted in lower billing levels in some government health programs, with billings for Medicare Part A and Part B - which cover inpatient care and many physician-prescribed drugs, respectively - dropping by 20 percent in districts with fraud strike forces. Also this fraud with medications contributed to national opioid epidemic.

According to the CDC, 42,000 people died from opioid overdoses in the U.S.in 2016 alone.

Numerous criminal cases announced on Thursday involved charges against medical professionals who authorities said had contributed to the country's opioid epidemic by participating in the unlawful distribution of prescription painkillers. Kitco Metals Inc. and the author of this article do not accept culpability for losses and/ or damages arising from the use of this publication. In addition, HHS announced today that from July 2017 to the present, it has excluded 2,700 individuals from participation in Medicare, Medicaid, and all other federal health care programs, which includes 587 providers excluded for conduct related to opioid diversion and abuse. One case involved a pharmacy chain in Texas with fraudulent orders of more than one million hydrocodone and oxycodone pills and selling them for millions of dollars to drug transporters.

Those claims were then submitted to organizations such as Medicaid and Medicare for services that were never provided.

In numerous cases patient recruiters, beneficiaries and others involved in the schemes were paid cash kickbacks in return for supplying beneficiary information to providers, allowing the providers to submit fraudulent bills to Medicare, according to court documents.

On Thursday, federal agencies announced their largest ever healthcare fraud enforcement action. Among those charged were 76 doctors, 23 pharmacists, 19 nurses and other medical personnel, the announcement states. According to the DOJ, these schemes resulted in over $2 billion in fraudulent billings, and involved over 13 million illegal doses of opioids. Several face charges of unlawfully dispensing controlled substances, including Dr. Peter Steiner, a psychiatrist who operated Kentuckiana Mental Health Associates, who is accused of prescribing unnecessary drugs.

At one Delray Beach sober home, two employees-and the owner-were charged with health care fraud, illegally recruiting patients, and collecting kickbacks.

In the Los Angeles area, most of the defendants were charged for taking part in schemes to defraud Medicare and other health insurance programs.

A complaint, information, or indictment is merely an allegation, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.

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