Friday, 22 February, 2019

Jeff Sessions announces largest healthcare fraud takedown in USA history

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 Jeff Sessions announces largest healthcare fraud takedown in USA history
Melissa Porter | 01 July, 2018, 09:28

The U.S. Department of Justice (DOJ) alleged the defendants were involved in a total of more than $2 billion in false billings to insurers for medically unnecessary prescription drugs and compounded medications that were never purchased or distributed to beneficiaries. In many cases, doctors, nurses, and pharmacists take advantage of people suffering from drug addiction in order to line their pockets.

The Centers for Medicare and Medicaid Services has recently attempted to cap the vast majority of opioid doses at 90 morphine milligram equivalents, but an increasingly vocal advocacy network of chronic pain patients forced the agency to preserve much of the flexibility in its own rules.

"The sustained losses are astronomical", U.S. Attorney Benjamin Greenberg said during a news conference in Miami, pointing out that South Florida was responsible for 20 percent of the defendants charged in the healthcare fraud takedowns across the country.

In the Southern District of Florida, 124 people were charged with offenses relating to their participation in various fraud schemes involving more than $337 million in false billings for services including home health care and pharmacy fraud. Charges include unlawful dispensing of controlled substances in a state struggling with a drug overdose epidemic. 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.

Officials said health care fraud is not only about the monetary damages, which saw some of those charged receiving hundreds of thousands of dollars of fraudulent proceeds, but the crackdown is also about public safety.

Charges against Dr. Chandra Reddy, a physician, and his wife, Vinodini, include conspiracy to commit health care fraud, federal authorities said.

"There is an incredible array of scams, some of which involve services that are never provided, and some of which use complicated and sophisticated ruses to hide illegal acts, such as bribes", said First Assistant U.S. Attorney Tracy L. Wilkison, in a statement.

Peresiper, a medical clinic business manager, was charged with conspiracy to pay health care kickbacks related to Pulmonary Solutions and Multi Care Medical NY, both in Brooklyn. The Medicare Fraud Strike Force operates in 10 locations nationwide.

In the Los Angeles area, most of the defendants were charged for taking part in schemes to defraud Medicare and other health insurance programs. A person is presumed innocent until proven guilty beyond a reasonable doubt in a court of law.