Charged in Crackdown on $1.3 Billion Health Care Fraud

Posted July 14, 2017

The Department of Justice, in conjunction with the Department of Health and Human Services (HHS) and other federal departments, revealed on Thursday the largest crackdown on health care fraud in USA history.

Sessions told reporters those suspects include 115 doctors, nurses and other medical professionals.

More than 120 of them were charged for prescribing and distributing opioids and other risky narcotics.

A representative from the Federal Bureau of Investigation told Sessions not to include meetings he had with Russian officials if they happened in his capacity as a senator, the Justice Department said.

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The DOJ said the people charged were illegally billing Medicare, Medicaid and health insurance programs for members of the armed forces.

More than 100 of the 416 defendants are charged with opioid scams in the largest such fraud crackdown in U.S history, he said.

In one instance, a fake drug rehabilitation facility in Palm Beach, Florida, recruited addicts using gift cards, visits to strip clubs and drugs so it could filed claims for more than $5.8 million in false tests and treatments, Sessions said. In Michigan, the US charged 32 people with billing Medicare for procedures and prescriptions that were medically unnecessary and where some of the narcotics were resold on the street.

"The suggestion that I participated in any collusion, that I was aware of any collusion with the Russian government, or hurt this country which I have served with honor for 35 years, or to undermine the integrity of our democratic process, is an appalling and detestable lie", Sessions said during a hearing before the Senate Intelligence Committee on June 16.

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"Thanks to these efforts, fewer criminals will be able to exploit our nation's opioid crisis for their own gain", said Tom Price, the secretary of health and human services.

The scheme involved submitting fraudulent claims - and receiving payments for prescription drugs - that were never filled by pharmacies or given to patients.

"We must address prescribers with questionable prescribing patterns for opioids to ensure that Medicare Part D is not paying for unnecessary drugs that are being diverted for resale or recreational use", the OIG concluded.

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