Feds charge 138, including 23 doctors, in $1.4B health care fraud cases

WASHINGTON — The Department of Justice on Friday announced criminal charges against 138 people, including 23 doctors, for alleged health-care fraud that authorities estimate involved $1.4 billion in losses.

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The charges also included 19 nurses and other licensed professionals and 96 other people across 31 federal districts across the United States, the DOJ stated in a news release.

Approximately $1.1 billion of fraud was committed through using telemedicine, according to the release. Telemedicine uses communications technology to evaluate and treat patients via remote access, CNBC reported.

The charges also targeted $29 million in COVID-19 health-care fraud, $133 million in substance abuse treatment and $160 million tied to other health-care fraud and illegal opioid schemes nationwide, according to the news release.

“This nationwide enforcement action demonstrates that the criminal division is at the forefront of the fight against health care fraud and opioid abuse by prosecuting those who have exploited health care benefit programs and their patients for personal gain,” Assistant Attorney General Kenneth A. Polite Jr., of the Justice Department’s criminal division, said in a statement. “The charges announced today send a clear deterrent message and should leave no doubt about the department’s ongoing commitment to ensuring the safety of patients and the integrity of health care benefit programs, even amid a continued pandemic.”

The telemedicine cases stemmed from prosecutions launched during 2019 and 2019 and involved allegations of billing Medicare for fraudulent genetic cancer testing, according to the release. The charges also involved telemedicine executives paying doctors and others to order unnecessary medical equipment, diagnostic testing and medications, either without actually interacting with patients or having a brief call with ones they had never met or seen.

The fraudulent claims were submitted by more than 43 criminal defendants across 11 judicial districts, according to the release.

“We are stopping corrupt medical professionals in their tracks,” Polite told reporters.

Nineteen people were charged in opioid-related fraud cases by the DOJ. Sixteen of them were doctors or other medical professionals, CNBC reported.

“Holding to account those responsible for health care fraud and diversion of prescription drugs is a priority for DEA,” Anne Milgram, administrator of the Drug Enforcement Administration, said in a statement. “These fraudulent activities prey on our most vulnerable – those in pain, the substance-addicted, and even the homeless – those who are most susceptible to promises of relief, recovery, or a new start.”

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