The Justice Department has just announced what it calls the “largest health care fraud takedown operation in American history.” 412 doctors, nurses, pharmacists and other licensed medical professionals have been charged with a massive kickback scheme involving the prescription of opioid medications. The scheme allegedly involved $1.3 billion in false billing to Medicare, Medicaid and TRiCARE insurance, and people were charged in 41 federal districts.
Attorney General Jeff Sessions lamented that the healthcare professionals “have chosen to violate their oaths and put greed ahead of their patients.”
“Amazingly, he added, “some have made their practices into multimillion dollar criminal enterprises.”
For example, a Florida rehabilitation facility allegedly billed $58 million in unnecessary tests and false treatments after recruiting opioid addicts with gift cards and visits to exotic dance clubs.
Another example is a group of six doctors in Michigan who are accused of intentionally prescribing unnecessary opioids and narcotics to their patients. More than 120 people involved in the prescription or distribution of narcotics were charged.
Beyond the dangerous practice of prescribing opioids and narcotics unnecessarily, the defendants are accused of illegally billing Medicare, Medicaid and the insurance program serving military service members and their families. In some cases, the insurance programs were billed for drugs that were never distributed to patients at all.
In addition to the criminal charges, the U.S. Department of Health and Human Services has initiated suspension actions against 295 physicians, nurses, pharmacists and other licensed healthcare professionals.
Sessions seemed genuinely outraged. “They seem oblivious to the disastrous consequences of their greed. Their actions not only enrich themselves, often at the expense of taxpayers, but also feed addictions and cause addictions to start,” he said.
This enforcement action involved a large number of federal agencies and 30 state Medicaid Fraud Control Units. While the Justice Department did not detail the sources of its information, Medicaid/Medicare fraud, false insurance billing and similar crimes are often discovered initially by internal whistleblowers.
It can be daunting to blow the whistle on wrongdoing in the workplace. If you are in the position to do so, you may worry that your employer or partners may retaliate against you. You may wonder if doing the right thing will cost you your livelihood.
If you are considering blowing the whistle on fraud against the government, you should know that the law provides a financial incentive for those willing to step up and protect the taxpayer from fraud like this. To protect your rights and ensure you receive any compensation you may be entitled to, we urge you to reach out to Fischer Legal Group.