tiptrot.com
tiptrot.com July 18, 2018


Justice Department Charges Over 600 People For Health Care Fraud

01 July 2018, 12:31 | Nichole Osborne

Feds charge 600 in opioid fraud that bilked $2B from government and insurers

U.S. Attorney General Jeff Sessions and Secretary of Health and Human Services Alex Azar arrive for a news conference to announce a nation-wide health care fraud and opioid enforcement action at the Justice Department in Washington U.S. Ju

Among those caught in the crackdown were 124 defendants in DOJ's South Florida district for false claims totaling more than $337 million.

The Department of Justice announced its largest healthcare fraud takedown ever, charging 601 people for falsely billing Medicare, Medicaid and the USA military's TRICARE program to the tune of more than $2 billion.

Kentucky has been hit by one of the nation's highest overdose death rates, a crisis fueled by a surge of opioid-based drug abuse including prescription painkillers, heroin and fentanyl.

Numerous criminal cases announced on Thursday involved charges against medical professionals who authorities said had contributed to the country's opioid epidemic by participating in the unlawful distribution of prescription painkillers. The alleged fraud included kickback schemes for surgeries, compounded drugs, home health services, Medicare Part D prescription drugs and hospice care. These are despicable crimes.

This latest takedown is the largest national healthcare fraud raid to date by the Medicare Fraud Strike Force, which was established in 2007 and includes state and federal law enforcement. That's why this Department of Justice has taken historic new steps to go after fraudsters, including hiring more prosecutors and leveraging the power of data analytics.


Attorney General Sessions and Secretary Azar were joined in the announcement by Acting Assistant Attorney John P. Cronan of the Justice Department's Criminal Division, Deputy Director David L. Bowdich of the FBI, Assistant Administrator John Martin of the Drug Enforcement Administration (DEA), Inspector General Daniel R. Levinson of the HHS Office of Inspector General (OIG), Deputy Chief Eric Hylton of IRS Criminal Investigation, Administrator Seema Verma of the Centers for Medicare and Medicaid Services (CMS), and Director Dermot F. O'Reilly of the Defense Criminal Investigative Service (DCIS).

The Centers for Medicare and Medicaid Services has recently attempted to cap the vast majority of opioid doses at 90 morphine milligram equivalents, but an increasingly vocal advocacy network of chronic pain patients forced the agency to preserve much of the flexibility in its own rules. About $858,000 was paid out in fraudulent proceeds as a result, he said. In many cases, investigators said, patient beneficiaries were paid cash kickbacks for supplying information to medical providers. Several face charges of unlawfully dispensing controlled substances, including Dr. Peter Steiner, a psychiatrist who operated Kentuckiana Mental Health Associates, who is accused of prescribing unnecessary drugs. 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.

Dr. Bingston Crosby and Lacy Black were charged with one count of conspiracy to commit health care fraud and each one count of paying or offering health care kickbacks.

Those charged were accused of cheating federal health programs, including Medicare and Medicaid, through false billing practices.

Omar Zoobi, a pharmacist and co-owner of Metro Pharmacy and Metro Rx Pharmacy LLC, and Gregory Sikorski, a physician's assistant: are included in a 10-count indictment charging each with one count of conspiracy to commit health care fraud and wire fraud, four counts of health care fraud, and one count of conspiracy to defraud the US and pay and receive health care kickbacks.



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