US charges hundreds in healthcare fraud, opioid crackdown

"Some Houston-area medical professionals, including doctors, nurses and pharmacological representatives, have chosen to break the law and place their greed before those whom they are charged to heal".

On June 28, the Department of Justice (DOJ) announced another record-breaking annual nationwide health care fraud "takedown".

"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. "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".

The charges announced aggressively target schemes billing Medicare, Medicaid, TRICARE, a health insurance program for members and veterans of the armed forces and their families, and private insurance companies for medically unnecessary prescription drugs and compounded medications that often were never even purchased or distributed to beneficiaries.

"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.

Though numerous cases also involved a variety of schemes to fraudulently bill government healthcare programs, officials sought in the latest crackdown to emphasize their efforts to combat the nation's opioid epidemic. In many cases, doctors, nurses, and pharmacists take advantage of people suffering from drug addiction in order to line their pockets.

In 2016, 42,000 people in the United States died from opioid overdoses, according to the US Centers for Disease Control and Prevention. These are despicable crimes. A list of states where the alleged fraud and crimes happened is available here.

"Today is a historic day - but our work is not finished". In the past fiscal year, the Department of Justice, including the Civil Division, has collectively won or negotiated over $2 billion in judgements and settlements related to matters alleging health care fraud.

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.

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".

Patino is accused of submitting claims to Medicare and Medicaid for health care that wasn't performed or wasn't necessary.


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