US charges 138 medical workers with US $ 1.4 billion fraud

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The Justice Department last week announced criminal charges against 138 doctors, nurses and licensed health professionals for their alleged involvement in fraud schemes worth around $ 1.4 billion.

The Justice Department has announced criminal charges against 138 doctors, nurses and licensed health professionals for their alleged involvement in fraud schemes worth around $ 1.4 billion. (Photo: PublicDomainPictures)Authorities charged 43 suspects from 31 federal districts with causing $ 1.1 billion of the loss through fraudulent claims in telemedicine – medical services offered online. The rest involved “sober homes,” COVID-19-related frauds, and opioid distribution programs.

Court documents show that some telemedicine executives paid doctors and nurses to order unnecessary medical supplies and pain relievers, often after having had a brief interaction with patients over the phone or not at all. The companies then submitted false statements to government insurers.

The money was then spent on “luxury items, including vehicles, yachts and real estate,” the statement said.

“The charges announced today send a clear deterrent message and should leave no doubt about the ministry’s continued commitment to ensuring patient safety and the integrity of health care delivery programs, even in the midst of a crisis. pandemic continues, “said the deputy attorney general of the Department of Justice. Criminal Division, Kenneth A. Polite Jr.

Law enforcement has shut down the activities of nine suspects involved in criminal schemes exploiting the COVID-19 pandemic and created bills worth more than $ 29 million.

Some of the suspects are said to have taken patient information from the CMS system to ask Medicare to pay for unnecessary and expensive tests.

Five defendants are believed to have participated in the misuse of the so-called supplier relief fund, a federal law created to support COVID-19 patients, then to go “play in a Las Vegas casino and pay a luxury car dealership ”.

With regard to “sober houses”, places that offer safe housing and favorable living conditions for people coming out of drug rehab programs, some of the suspects are accused of having subjected patients to medical tests and sessions. of unnecessary and costly therapy worth several thousand dollars. This resulted in losses of over $ 133 million for private insurers.

Finally, in a country already grappling with massive opioid addiction, authorities have indicted 19 suspects for fraudulently prescribing more than 12 million doses of opioids to patients and causing a loss of more than $ 14 million.

More than 60 alleged participants in the programs have reportedly submitted more than $ 145 million “in false and fraudulent claims to Medicare, Medicaid, TRICARE and private insurance companies for medically unnecessary and often never provided treatment.”

FBI Deputy Director of Criminal Investigations Calvin Shivers said despite a lingering pandemic, the FBI and its law enforcement partners “remain committed to protecting U.S. taxpayers and businesses the high cost of healthcare fraud “.


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