In what the U.S. Department of Justice called on Thursday the largest health care fraud enforcement action in the agency s history, more than 400 defendants nationwide have been charged with defrauding taxpayers of $1.3 billion.
The takedown is a strong reflection of one of the new announced priorities at the DOJ under the Trump administration and new U.S. Attorney General Jeff Sessions: drugs, particularly opioid painkillers and other prescription narcotics.
Takedowns have become annual demonstrations of the federal government s commitment to combatting the health care fraud that has cost it and taxpayers billions of dollars in recent years.
In remarks prepared to be delivered at a press conference Thursday, Sessions said that while the charges marked a historic day, the work of the department in this enforcement area isn t over. In fact, it is just beginning, he said. We will continue to find, arrest, prosecute, convict, and incarcerate fraudsters and drug dealers wherever they are.
We are sending a clear message to criminals across the country: we will find you, Sessions added. We will bring you to justice. And, you will pay a very high price for what you have done.
Of the 412 charged individuals, 115 are licensed medical professionals, and 56 of those 115 are physicians, according to the DOJ. The defendants are charged with billing Medicare, Medicaid and Tricare a health insurance program for military members, veterans and their families for medically unnecessary prescription drugs and compounded medications that often were never even purchased or distributed to beneficiaries, as well as submitting claims for treatments that were medically necessary but often never provided.
In some of these cases, patient recruiters and beneficiaries were allegedly paid kickbacks for providing beneficiary information to providers who could then submit false bills to Medicare for services that were medically unnecessary or never provided.
More than 120 of the defendants, including physicians, were allegedly involved in the unlawful distribution of opioids and other prescription narcotics conduct that contributes to the opioid epidemic and has proved to be a particular focus for the DOJ.
Too many trusted medical professionals like doctors, nurses, and pharmacists have chosen to violate their oaths and put greed ahead of their patients, Sessions said in his prepared remarks. They seem oblivious to the disastrous consequences of their greed ... [which] are real: emergency rooms, jail cells, futures lost, and graveyards.
In addition to action from the DOJ, the Trump administration has also formed a Commission on Combating Drug Addiction and the Opioid Crisis and high-level officials such as Health and Human Services Secretary Tom Price have stated that they are prioritizing the issue.