September 23, 2018

US charges hundreds in healthcare fraud, opioid crackdown

01 July 2018, 09:30 | Rodolfo Wallace

AG Sessions Announces 601 Charged Amid Largest Opioid Crackdown

U.S. Attorney General Jeff Sessions arrives for a news conference to announce a nation-wide health care fraud and opioid enforcement action at the Justice Department in Washington

"We've charged another 162 people, including 32 doctors, with illegal distribution of opioids - just opioids - so, this is the most doctors and the most medical personnel, unfortunately, and the most fraud that the Department of Justice has ever taken on in any single enforcement action", said the attorney general.

U.S. Attorney for the District of Idaho Bart M. Davis announced the District of Idaho's participation in the National Health Care Fraud Takedown.

The alleged schemes involved medically unnecessary prescription narcotics that often were not distributed to patients, according to the Justice Department. According to the U.S. Centers for Disease Control and Prevention, the epidemic caused more than 42,000 deaths from opioid overdoses in the United States in 2016.

While the Justice Department has been conducting investigations into some opioid manufacturers like OxyContin maker Purdue Pharma LP, the cases stemming from the sweep did not focus on wrongdoing by major corporations.

The charges against South, 47, of Florence, Alabama, Nelson, 40, of Santa Rosa Beach, Florida, Boykin, 45, of San Antonio, Texas, Whitten, 55, of Columbus, Georgia, and Cardozo, 28, of Largo, Florida, add to eight Global sales representatives previously charged by the U.S. Attorney's Office and who all have pled guilty to the conspiracy and scheme.

The facility submitted more than $106 million in claims for addiction treatment services. The cases allege health care fraud and kickback scams involving surgeries, compounded drugs, home health services, Medicare Part D prescription drugs and hospice care.

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The charges were filed in federal court in Brooklyn and Central Islip, New York as part of a nationwide health care fraud crackdown, led by the Medicare Fraud Strike Force, which resulted in criminal charges against 601 individuals involving an alleged $2 billion in fraudulent claims.

Doctors, pharmacists, nurses and other medical officials are among the charged. They were all participants in fraud schemes, which resulted in the Department of health lost more than $ 2 billion.

In "many" cases, the DOJ said, patient recruiters, beneficiaries and other co-conspirators were allegedly paid cash kickbacks in return for supplying beneficiary information to providers, so the providers could submit fraudulent bills to Medicare. The charges stem from Moorehead using the identities of multiple hospital patients with prescriptions for pain medications containing hydrocodone to dispense and divert the pills to his own personal use, and falsely indicating in Medicare beneficiaries' medical records that those medications were administered to the patients.

The takedown is considered to be one of the largest health care fraud busts in U.S history.

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

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