Monday, 10 December, 2018

Largest Health Care Fraud Takedown in U.S. History

AG Sessions Announces 601 Charged Amid Largest Opioid Crackdown Justice Dept arrests 601 people, including doctors, for health care fraud and opioid-related crimes
Gustavo Carr | 01 July, 2018, 09:30

The Department of Justice announced its largest healthcare fraud takedown ever, charging 601 people for falsely billing Medicare, Medicaid and the US military's TRICARE program to the tune of more than $2 billion.

The arrests came as part of what the department said was the largest health care fraud takedown in usa history.

The massive enforcement initiative - which spanned 58 federal districts - swept up 165 doctors, nurses and other licensed health professionals, including 76 doctors accused of prescribing and distributing opioids and other prescription painkillers.

According to the Centers for Disease Control and Prevention, approximately 115 Americans die each day from opioid-related overdoses. Steiner, who operated a mental health and opioid addiction practice, prescribed medically unnecessary drugs and unlawfully distributed opiates, Coleman said.

The charges, while announced together, include a number of unrelated cases, including 84 opioid cases involving more than 13 million illegal doses of opioids. 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.

On Thursday, federal agencies announced their largest ever healthcare fraud enforcement action.

Officials said health care fraud is not only about the monetary damages, which saw some of those charged receiving hundreds of thousands of dollars of fraudulent proceeds, but the crackdown is also about public safety.

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U.S. Attorney Town said, "The defendants in the north Alabama case helped their employer, Global Compounding Pharmacy, defraud millions from Medicare, Blue Cross Blue Shield of Alabama and other insurance systems by pushing unnecessary medications and billing for reimbursement".

South, Nelson, Boykin and Whitten also are charged with varying counts of health care fraud, and Whitten also faces a charge of aggravated identity theft.

The indictment charges Irena Shut, 41, an attorney who lives in Hidden Hills, with paying kickbacks to two podiatrists to authorize prescriptions written on pre-printed prescription pads created to maximize insurance payments, regardless of the medical need for an expensive compounded formulary for each "patient".

Charges against Dr. Chandra Reddy, a physician, and his wife, Vinodini, include conspiracy to commit health care fraud, federal authorities said.

"It takes a special kind of person to prey on the sick and vulnerable as happened in many of these health care fraud schemes", said Deputy Chief of IRS Criminal Investigation Eric Hylton. The Medicare Fraud Strike Force operates in nine locations nationwide.

Two other defendants are accused of operating three "false-front" medical clinics that resulted in $4.7 million in false medical billings submitted to three insurance companies and $258,000 paid in false billings, the prosecutor said. A person is presumed innocent until proven guilty beyond a reasonable doubt in a court of law.