Hundreds Charged In $1.3 Billion Healthcare Schemes
- Author: Rogelio Becker Jul 15, 2017,
Jul 15, 2017, 0:14
Defendants include a physician and a clinic owner who were indicted for conspiracy to distribute and dispense controlled substances and other charges in connection with a purported pain management clinic that is alleged to have been the highest prescribing hydrocodone clinic in Houston, where 60 to 70 people were seen daily.
Around $108 million of the fraudulent billings came from Texas.
"This event again highlights the enormity of the fraud challenge we face", Attorney General Jeff Sessions said, "too many trusted medical professionals...have made their practices into multimillion dollar criminal enterprises".
Nineteen of the 24 people charged in Arkansas have been arrested, said Chris Givens, assistant US attorney for the Eastern District of Arkansas.
In all, the fraudulent insurance claims - many of which related to opioid painkillers - are said to total $1.3 billion.
Seventeen defendants in California charged for their alleged roles in schemes to defraud Medicare out of approximately $147 million.
56 of the defendants were doctors accused of billing Medicare for prescription drugs that were never purchased or run so-called pill mills, where they prescribed opioids to patients for cash transactions.
"As a result of this operation, 295 health care providers are now in the process of being suspended or banned from participation in federal health programs", said Sessions.
"We are sending a clear message to criminals across the country: we will find you", said Sessions at a press briefing. More than 74,000 pills were obtained using those prescriptions. Last year, 14.4 million of the 43.6 million, or one in three, beneficiaries filled at least one prescription for opioids.
Last year, approximately 59,000 people in the USA died from drug overdoses, many of them linked to opioid abuse, according to the Drug Enforcement Administration. Canada ranks second after the USA, but when it comes to hydrocodone use, for example, people in the United States use more than 48 times as much of this drug than people in Canada. More than 52,000 Americans died of overdoses in 2015 - a record - and experts believe the numbers have continued to rise.
The crackdown was coordinated by multiple federal and state law enforcement agencies. States and counties around the country are suing both the manufacturers and distributors of prescription opioids for fueling the addiction epidemic by ignoring suspect surges in orders that can not be justified by local patient populations.