DOJ announces 600 charges in health care fraud crackdown

DOJ announces 600 charges in health care fraud crackdown

DOJ announces 600 charges in health care fraud crackdown

The arrests came in dozens of unrelated prosecutions the Justice Department announced together as part of an annual healthcare fraud takedown.

"These are despicable crimes", Attorney General Jeff Sessions said in a statement.

The Kentucky charges are part of a nationwide enforcement action against health care fraud involving hundreds of defendants, including doctors, nurses and other medical professionals. The nationwide sweep includes charges against 165 doctors, nurses and other licensed medical professionals who allegedly participated in health care fraud schemes.

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.

Over 42,000 Americans died from opioid overdoses in 2016, data from the U.S. Centers for Disease Control and Prevention showed. A list of states where the alleged fraud and crimes happened is available here.

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"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. "Our office will aggressively fight health care fraud and prosecute those individuals who contribute to the opioid epidemic. This is the most fraud, the most defendants, and the most doctors ever charged in a single operation-and we have evidence that our ongoing work has stopped or prevented billions of dollars' worth of fraud". He was arraigned and pleaded guilty to healthcare fraud before United States District Judge Denis Hurley at the federal courthouse in Central Islip.

Of that staggering total, about 125 defendants were charged in South Florida with filing almost $340 million in fraudulent claims for opioid addiction treatment, home healthcare and prescription drugs covered by taxpayer-funded programs and other insurance plans. They were all participants in fraud schemes, which resulted in the Department of health lost more than $ 2 billion. Federal officials said they also involved patient recruiters, beneficiaries and other co-conspirators paying kickbacks in return for providing beneficiary information to providers so providers could submit false Medicare claims.

Keep in mind the federal task force responsible for the takedown is focused on Medicare and Medicaid fraud specifically, but it cooperates with the private payer community regularly to chase down bad operators.

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".

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