Gov’t charges 301 with $900M in false billing

Thursday, June 23, 2016

WASHINGTON – A $900-million takedown by the Medicare Fraud Strike Force on June 22, the largest in history, included schemes involving durable medical equipment.

The nationwide sweep resulted in criminal and civil charges against 301 individuals, including 61 doctors, nurses and other licensed medical professionals, for alleged false billings.

“As this takedown should make clear, healthcare fraud is not an abstract violation or benign offense—it is a serious crime,” said U.S. Attorney General Loretta Lynch, who announced the takedown with Department of Health and Human Services Secretary Sylvia Burwell. “The Department of Justice is determined to continue working to ensure that the American people know that their healthcare system works for them—and them alone.”

The individuals have been charged with various healthcare fraud-related crimes, including conspiracy to commit healthcare fraud, violations of the anti-kickback statutes, money laundering and aggravated identity theft. The crimes involve various medical treatments and services, including home health care, psychotherapy, physical and occupational therapy, durable medical equipment and prescription drugs.

In the Southern District of California, five individuals, including a doctor and pharmacist, were charged in a scheme to pay bribes and kickbacks to doctors in exchange for prescribing durable medical equipment and compound pain creams that were not medically necessary. The indictment alleges that, in this case alone, about $27 million in false and fraudulent claims were submitted.

The cases are being prosecuted and investigated by U.S. attorneys offices nationwide.

Including these most recent actions, nearly 1,200 individuals have been charged in national takedown operations, which have involved more than $3.4 billion in fraudulent billings.