June 28, 2018
Contact: SA Debbie Webber
Phone Number: (571) 362-4803
National healthcare fraud takedown results in charges against over 600 individuals responsible for over $2 billion in fraud losses
(NEW ORLEANS) - As a part of the largest Health Care Fraud Enforcement Action in Department of Justice history, the DEA and the Eastern District of Louisiana Strike Force announces charges against 11 individuals.
In Baton Rouge, Louisiana the DEA and United States Attorney’s Office announced new charges against 26 individuals for health care fraud, opioid-related crimes, and related offenses.
Nine defendants were arrested this week in the Southern District of Alabama for their roles in the unlawful distribution of opioids, announced the DEA and the U.S. Attorney’s Office. They were charged with the distributions of controlled substances to include, Morphine, Hydrocodone, Oxycodone, Oxymorphone, OxyContin, or Fentanyl. Three of the defendants are from Selma and the remaining six are from Mobile.
Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Alex M. Azar III, announced today the largest ever health care fraud enforcement action by the Medicare Fraud Strike Force, involving 590+ charged defendants across 56 federal districts, including 150+ doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving approximately $2 billion in false billings. Of those charged, over 150 defendants, including doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Twenty-nine state Medicaid Fraud Control Units also participated in today’s arrests. In addition, HHS announced today that from June 2017 to the present, 587 providers have been served with exclusion notices for conduct related to opioid diversion and abuse.
Attorney General Sessions and Secretary Azar were joined in the announcement by Acting Assistant Attorney General 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 (CI), Director Alec Alexander of the Centers for Medicare and Medicaid Services (CMS) Center for Program Integrity and Director Dermot F. O’Reilly of the Defense Criminal Investigative Service (DCIS).
Today’s enforcement actions were led and coordinated by the Criminal Division, Fraud Section’s Health Care Fraud Unit in conjunction with its Medicare Fraud Strike Force partners, a partnership between the Criminal Division, U.S. Attorney’s Offices, the FBI and HHS-OIG. In addition, the operation includes the participation of the DEA, DCIS, IRS-CI, Department of Labor, other various federal law enforcement agencies, and State Medicaid Fraud Control Units.
The charges announced today 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 and/or distributed to beneficiaries. The charges also involve individuals contributing to the opioid epidemic, with a particular focus on medical professionals involved in the unlawful distribution of opioids and other prescription narcotics, a particular focus for the Department. According to the CDC, approximately 115 Americans die every day of an opioid-related overdose.
“Health care fraud is a betrayal of vulnerable patients, and often it is theft from the taxpayer,” said Attorney General Sessions. “In many cases, doctors, nurses, and pharmacists take advantage of people suffering from drug addiction in order to line their pockets. These are despicable crimes. That’s why this Department of Justice has taken historic new steps to go after fraudsters, including hiring more prosecutors and leveraging the power of data analytics. Today the Department of Justice is announcing the largest health care fraud enforcement action in American history. 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. I want to thank our fabulous partners with the FBI, DEA, our Health Care Fraud task forces, HHS, the Defense Criminal Investigative Service, IRS Criminal Investigation, Medicare, and especially the more than 1,000 federal, state, local, and tribal law enforcement officers from across America who made this possible. By every measure we are more effective at finding and prosecuting medical fraud than ever.”
“Every dollar recovered in this year’s operation represents not just a taxpayer’s hard-earned money—it’s a dollar that can go toward providing healthcare for Americans in need,” said HHS Secretary Azar. “This year’s Takedown Day is a significant accomplishment for the American people, and every public servant involved should be proud of their work.”
“The abuse of prescription drugs remains a significant problem in communities across the nation, to include Alabama. For the health and safety of our citizens, DEA will continue to target the illegal diversion of these pharmaceuticals, which can destroy lives. We hope that these indictments and arrest will serve as a reminder to anyone who might illegally divert pharmaceuticals that they will be held accountable for the harm they cause,” said Stephen G. Azzam, Special Agent-in-Charge of the DEA’s New Orleans Field Division.
According to court documents, the defendants allegedly participated in schemes to submit claims to Medicare, Medicaid, TRICARE, and private insurance companies for treatments that were medically unnecessary and often never provided. In many cases, patient recruiters, beneficiaries and other co-conspirators were allegedly paid cash kickbacks in return for supplying beneficiary information to providers, so that the providers could then submit fraudulent bills to Medicare for services that were medically unnecessary or never performed. Collectively, the doctors, nurses, licensed medical professionals, health care company owners and others charged are accused of submitting a total of over $2 billion in fraudulent billings. The number of medical professionals charged is particularly significant, because virtually every health care fraud scheme requires a corrupt medical professional to be involved in order for Medicare or Medicaid to pay the fraudulent claims. Aggressively pursuing corrupt medical professionals not only has a deterrent effect on other medical professionals, but also ensures that their licenses can no longer be used to bilk the system.