345 Defendants Charged in $6 Billion National Health Care Fraud and Opioid Takedown
A Department of Justice (DOJ) press release dated September 30, 2020 announced the largest health care fraud and opioid enforcement action in Department of Justice history with the indictment of 345 defendants across 51 federal districts, including more than 100 doctors, nurses, and other licensed medical professionals.
The defendants have been charged with submitting $6 billion in false and fraudulent claims to federal health care programs and private insurers, with $4.5 billion connected to telemedicine, $845 million connected to substance abuse treatment facilities, and $806 million connected to other health care fraud schemes across the country.
This operation was a nationwide effort to combat health care fraud and opioid distribution. Acting Assistant Attorney General Brian C. Rabbitt said, “These cases hold accountable those medical professionals and others who have exploited health care benefit programs and patients for personal gain. The cooperative law enforcement actions 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 national health emergency.”
Drug Enforcement Administration (DEA) Assistant Administrator Tim McDermott asserted in the press release, “The opioid epidemic our country is battling is exacerbated when unscrupulous individuals seek to profit from people, in particular those confronting addiction.” He continued, “When doctors, pharmacists, and individuals exploit the weakness of a fellow human being in order to line their own pockets, DEA will use every tool at its disposal to stop and bring them to justice.”
Among the defendants are telemedicine executives who allegedly paid doctors and nurse practitioners to order unnecessary medical equipment, diagnostic testing, and pain medications without patient interaction. Furthermore, some defendants allegedly sent patients to drug/alcohol rehab facilities (sober homes) and submitted millions of dollars of false or fraudulent claims for unnecessary treatments. Another group of defendants were allegedly involved in illegally prescribing and distributing opioids.
In addition to the enforcement actions, the DOJ announced in the same press release the establishment of the National Rapid Response Strike Force of the Health Care Fraud Unit of the Criminal Division’s Fraud Section. Their mission is to investigate and prosecute fraud cases involving major health care providers that operate in multiple jurisdictions.
The cases announced in this takedown are being prosecuted by Health Care Fraud and Appalachian Regional Prescription Opioid (ARPO) Strike Force teams from the Criminal Division’s Fraud Section, along with 43 U.S. Attorneys’ Offices nationwide and agents from HHS-OIG, FBI, DEA, and various other federal and state law enforcement agencies.