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Health care fraud probes target doctors, nurses, others

  • Doctors, nurses among those charged with fraud
  • Alleged crimes cost federal government $1.6 billion
  • Most charges involve billing for unneeded meds, procedures

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(NewsNation) — Halfway through 2024, the Justice Department says it has charged nearly 200 people allegedly involved in about half a dozen medical fraud schemes involving potential losses of nearly $3 billion. Of those charged, 76 are doctors, nurses and other health care professionals.

“If you profit from the unlawful distribution of controlled substances, you will be held accountable,” said Attorney General Merrick B. Garland in a Justice Department news release. “The Justice Department will bring to justice criminals who defraud Americans, steal from taxpayer-funded programs, and put people in danger for the sake of profits,” he added.

The alleged criminal activity occurred in 32 places around the country and involved a wide variety of frauds.

Four people in Arizona are accused of filing $900 million in false and fraudulent claims to Medicare for amniotic wound grafts. The expensive grafts were applied to people who didn’t need them, terminally ill patients and to some patients without the knowledge of their doctors.

The CEO and president of a San Francisco clinic were arrested on charges of prescribing and selling about 1.5 million Adderall pills and other stimulants over the internet.

The owners of three pharmaceutical wholesale distributors are accused of selling adulterated and misbranded HIV drugs, often refilling used drug bottles with counterfeit medications or something else entirely. The Justice Department says the scheme brought in about $90 million.

Several people in Florida and Arizona are accused of making false and fraudulent claims for patients seeking treatment for drug or alcohol addiction. One person allegedly paid kickbacks for referrals of homeless people to sign up for treatment that was never provided but billed to Medicaid.

A total of 36 people face charges for allegedly submitting more than $1 billion in false telemedicine treatment claims. In one case, a doctor submitted claims based on remote patient visits lasting no longer than 30 seconds.

Many other cases involve allegations of false billings, prescribing unnecessary opioids, ordering tests that were never conducted and treatments that were never provided.

“Health care fraud victimizes patients, endangers the health of vulnerable people, and plunders health care programs,” said FBI Director Christopher Wray.

All told, the government has filed criminal charges against 193 people in 32 federal districts over schemes that hoped to steal about $2.75 billion, and actually did steal $1.6 billion. The government also seized more than $231 million in cash, vehicles, gold and other assets.

Crime

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