Feds Charge Hundreds—Including Doctors and Nurses—with $1.3 Billion in Healthcare Fraud

The U.S. departments of Health and Human Services (HHS) and Justice (DOJ) have announced charges against 412 defendants in the largest healthcare fraud action yet by the Medicare Fraud Strike Force. Among those charged are 115 doctors, nurses, and other licensed medical professionals. More than 120 of the defendants are charged with taking part in prescribing and distributing opioids, as well as other narcotics. All told, the alleged fraud schemes amount to $1.3 billion in falsified billing. Thirty Medicaid Fraud Control Units also participated in today’s arrests. In addition, HHS has initiated suspension actions against 295 providers, including doctors, nurses, and pharmacists. The charges stem from schemes HHS and the DOJ say have involved billing Medicare, Medicaid, and TRICARE (which covers veterans, active-duty military personnel, and their families) for medically unnecessary prescription drugs and compounded medications that often were never even purchased or distributed to beneficiaries. In addition, some medical professionals have been charged with distributing opioids and other prescription narcotics unlawfully. (The latter charges reflect a particular focus for the agencies, given an opioid-abuse epidemic that sees approximately 91 Americans die every day of an opioid-related overdose, according to the Centers for Disease Control and Prevention.) Attorney General Jeff Sessions went so far as to call medical practices that were used as conduits to the schemes “multimillion dollar criminal enterprises” that “feed addictions and cause addictions to start.” Sessions also vowed that more arrests, prosecutions, convictions, and incarcerations lay ahead. So far, charges have been filed against parties in over 30 states and Puerto Rico.