By a Biometrica staffer
Charges have been brought against 26 individuals in the Central District of California and 8 others in the states of Arizona and Oregon for defrauding the Medicare and Medicaid programs, resulting in $257 million and $1 million in billings respectively. Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division announced the healthcare fraud enforcement action on September 18.
Of the 26 charged in California, 14 were either doctors or medical professionals; and 3 of the 8 charged in Arizona and Oregon were also licensed medical professionals. The charges aggressively target schemes billing Medicare and Medicaid for services, testing, and prescriptions that were not medically necessary or not actually provided to beneficiaries, the Department of Justice’s (DoJ) Office of Public Affairs said in a statement.
“Today’s action shows that our ability to detect and prosecute health care fraud grows more sophisticated with each passing day. The Department of Justice is using every tool at our disposal to target the medical professionals and others who place their personal greed above the public good,” said Assistant Attorney General Benczkowski.
The enforcement action was led and coordinated by the Health Care Fraud Unit of the Criminal Division’s Fraud Section in conjunction with its Medicare Fraud Strike Force (MFSF) partners, a partnership between the Criminal Division, U.S. Attorney’s Offices, the FBI and the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG). In addition, the operation included the participation of various other agencies.
“Corruption drains dollars from private insurers and public programs such as Medicare and Medicaid. This office will continue to hold accountable anyone – including medical professionals – who seek to bilk our nation’s health care system,” said U.S. Attorney Nick Hanna of the Central District of California.
The DoJ obtained more than $2.8 billion in settlements and judgments from civil cases involving fraud and false claims against the government in the fiscal year that ended September 30 2018. Of those, $2.5 billion involved the healthcare industry, including drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories, and physicians.
Note – The charges and allegations contained in the indictments are merely accusations. The defendants are presumed innocent until and unless proven guilty.
Source – DoJ Office of Public Affairs
For a complete list of the individuals charged in the above case, please click here.