Sunday, 18 November, 2018


US charges 601 people in healthcare fraud linked to the opioid crisis

U.S. charges 601 people in health care fraud opioid takedown US charges 601 people in healthcare fraud linked to the opioid crisis
Patty Aguilar | 01 July, 2018, 00:41

"Health care fraud schemes cost Americans billions of dollars every year through higher premiums and tax money stolen from public programs, such as Medicare", First Assistant U.S. Attorney Tracy L. Wilkison 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.

Federal agencies on Thursday announced charges in what Attorney General Jeff Sessions called "the largest health care fraud takedown in American history", an investigation into over $2 billion in alleged fraud by doctors, pharmacists, and nurses. In its own announcement, HHS claimed that, since the last takedown, it has issued exclusion notices to 587 individuals, including 67 doctors, 402 nurses, and 40 people involved in pharmacy services "whose conduct has contributed to opioid diversion and abuse". Physicians prescribed and distributed by opioid medications, of which there is a dependence among those they were not needed. The nationwide sweep includes charges against 165 doctors, nurses and other licensed medical professionals who allegedly participated in health care fraud schemes.

The defendants allegedly submitted claims to Medicare, Medicaid, TRICARE and private insurance companies for treatments that were medically unnecessary and often never provided, according to the DOJ. These are despicable crimes. About $858,000 was paid out in fraudulent proceeds as a result, he said.

The defendants allegedly recruited patients, paid kickbacks, and defrauded health care benefit programs for widespread fraudulent urine testing.

"This data analytics team can tell us important information, like who is prescribing the most drugs, who is dispensing the most drugs, and whose patients are dying of overdoses", he said. Separately, dozens of distributors and drug manufacturers are facing charges from cities, states, counties, and Native American tribes in a consolidated case in an OH federal court that could yield an unprecedented settlement.

Dr. Chandra Reddy and his wife Vinodini Reddy were charged with two counts conspiracy to commit health care fraud and one count of conspiracy for making false statements.

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 Medicare Fraud Strike Force operations are part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. "Texas Attorney General Ken Paxton is committed to continuing to work with our federal partners to uncover waste, fraud, and abuse in the Medicare and Medicaid systems", said Stormy Kelly, Division Chief within the Medicaid Fraud Control Unit of the Office of Texas Attorney General.

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