Justice Department charges 601 in healthcare fraud, opioid probe

U.S. charges 601 people in health care fraud opioid takedown

U.S. charges 601 people in health care fraud opioid takedown

"Some of our most trusted medical officials, professionals, look at their patients, vulnerable people suffering from addiction, and they see dollar signs", Sessions said.

Without alleging criminal activity by patients, the report also identified almost a half-million Medicare beneficiaries said to be receiving regular opioid dosages since 2016 that exceed prescribing guidelines issued by the Centers for Disease Control and Prevention.

Charles Gerardi is accused of billing Medicare for unnecessary psychotherapy and billing for psychotherapy when he was actually performing medication management.

The charges, while announced together, include a number of unrelated cases, including 84 opioid cases involving more than 13 million illegal doses of opioids.

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 (MFSF) partners, a partnership between the Criminal Division, U.S. Attorney's Offices, the Federal Bureau of Investigation and HHS-OIG. In many cases, the charges are that patient recruiters, beneficiaries and other co-conspirators were paid cash kickbacks in return for supplying beneficiary information to providers, so that the providers could then submit fraudulent bills to Medicare. About $858,000 was paid out in fraudulent proceeds as a result, he said.

Sessions also touted law enforcement amid national efforts to combat the opioid crisis. Separately, dozens of distributors and drug manufacturers are facing charges from cities, states, counties, and Native American tribes in a consolidated case in an OH federal court that could yield an unprecedented settlement. Among those charged were 76 doctors, 23 pharmacists, 19 nurses and other medical personnel, the announcement states.

Dr. Chandra Reddy and his wife Vinodini Reddy were charged with two counts conspiracy to commit health care fraud and one count of conspiracy for making false statements.

"These individuals rob this nation of its precious taxpayer dollars", said FBI Special Agent in Charge (SAC) Perrye K. Turner. Health care fraud investigations, involving both public and private insurance programs, are considered a high priority throughout the FBI.

Last year, the DOJ charged more than 400 people for allegedly participating in health care fraud activities totaling approximately $1.3 billion in false billings.

According to court documents, Global hired sales representatives who were located in various states and were responsible for generating prescriptions from physicians and other prescribers.

Ashlee McFarlane, former federal prosecutor and partner at Gerger Khalil & Hennessy, told Healthcare Dive via email that the takedown shows DOJ "is committing significant resources to criminally prosecuting anyone who prescribes drugs or distributes opioid prescriptions outside the normal course of medical practice".

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