Charges hundreds in major healthcare fraud, opioid crackdown

Sunday, 01 Jul, 2018

Among the accused are 76 doctors, 23 pharmacists and 19 nurses.

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

Greenberg focused on the theme of fighting scofflaw drug treatment centers and sober homes for opioid addicts during his presentation, which echoed a news conference led by U.S. Attorney General Jeff Sessions in Washington, D.C. Sessions has made fighting the nation's opioid crisis, fueled by an average of 115 overdose deaths every day, a top priority of the Trump administration. "For example, one doctor allegedly defrauded Medicare of more than $112 million by distributing 2.2 million unnecessary doses of drugs like oxycodone and fentanyl".

Authorities said the nationwide schemes involved billing Medicare, Medicaid, and private insurance companies for medically unnecessary prescription drugs and other medications that were sometimes never purchased or distributed.

The U.S. Attorney's Office announced on June 28 it had filed 16 criminal cases against 33 Southern California defendants as part of a nationwide sweep to prosecute the alleged perpetrators of roughly $2 billion in health care fraud. These are despicable crimes.

Without alleging criminal activity by patients, the report also identified almost a half-million Medicare beneficiaries said to be receiving regular opioid dosages since 2016 that exceed prescribing guidelines issued by the Centers for Disease Control and Prevention.

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Attorney General Sessions and Secretary Azar were joined in the announcement by Acting Assistant Attorney John P. Cronan of the Justice Department's Criminal Division, Deputy Director David L. Bowdich of the FBI, Assistant Administrator John Martin of the Drug Enforcement Administration (DEA), Inspector General Daniel R. Levinson of the HHS Office of Inspector General (OIG), Deputy Chief Eric Hylton of IRS Criminal Investigation, Administrator Seema Verma of the Centers for Medicare and Medicaid Services (CMS), and Director Dermot F. O'Reilly of the Defense Criminal Investigative Service (DCIS).

Last year, the DOJ charged more than 400 people for allegedly participating in health care fraud activities totaling approximately $1.3 billion in false billings.

The arrests came in dozens of unrelated prosecutions the Justice Department announced together as part of an annual healthcare fraud takedown. Crosby is accused of paying an alleged co-conspirator to recruit patients by promising them cash or other inducements, and Crosby allegedly billed for services not rendered, they said.

Ashlee McFarlane, former federal prosecutor and partner at Gerger Khalil & Hennessy, told Healthcare Dive via email that the takedown shows DOJ "is committing significant resources to criminally prosecuting anyone who prescribes drugs or distributes opioid prescriptions outside the normal course of medical practice".

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