United States Department of Justice (DOJ) officials released a press release on Thursday, July 13, 2017, announcing that a Medicare Fraud Strike Force had made as many as 400 arrests in the past few days across Southern California. As for the charges the defendants face, they range from illegally prescribing or distributing opioids to filing fradulent Medicare claims.
In its press release, the DOJ notes that the task force was initially tipped off to the impropriety when they began investigating a Palm Beach area drug rehab facility. In the course of their investigation, they noted that the facility had long been attempting to woo addicts by providing them with visits to gentleman’s clubs, gift cards and drugs.
Investigators determined that, in order to cover the costs of these perks, the company billed both insurance companies and Medicare to tune of $58 million. The providers claimed they had provided patients tests and treatments and were simply filing claims for them.
As for those arrested, the group included nurses, doctors and other licensed medical providers. All together, it’s believed that they conspired to defraud Medicare of $1.3 billion dollars. Among the group of defendants, 120 were accused of having unnecessarily prescribed addicts with potentially harmful narcotics. Another four are accused of having diverted drugs as well as receiving health care kickbacks.
At least 17 were arrested for their role in filing fictitious Medicare claims that ultimately cost the government agency $147 million. As far as that scheme is concerned, one defendant is alleged to have crafted a $41.5 million scheme to defraud both private insurers and Medicare.
It’s quite possible that these individuals will either agree to plea deals or, in some cases, never be convicted of these crimes they’ve been charged with. Due to the public nature of their professions, it’s possible that details surrounding their alleged crimes and arrests will be posted to the state medical board’s website. This could greatly impact these individuals’ ability to become gainfully employed in the future.
Because of this, these defendants should work closely with an Orange County, California, white collar crime defense attorney to aggressively fight the charges.
Source: The OC Register, “Hundreds ensnared in Justice Department health-care fraud crackdown on $1.3 billion in false billings,” Teri Szforza, July 13, 2017
