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Government executes largest healthcare fraud take-down in history

The Department of Justice (DOJ) recently announced the arrest of hundreds of individuals in the “biggest healthcare fraud take-down in history.” The DOJ arrested 601 people from 58 different federal districts for filing $2 billion in false claims.

The DOJ stated two main focuses were used during this investigation:

  • Billing practices. The agency focused on illegal billing practices. Medicare, Medicaid, TRICARE and other private insurance companies were allegedly illegally billed for prescriptions that were medically unnecessary or never filled as well as services that were never provided.
  • Patient recruiters. The DOJ also notes the use of patient recruiters was a focus in these investigations. The scheme allegedly involved the use of patient recruiters to supply information to the accused. In exchange for providing this information, patient recruiters received a kickback payment.

The agency has accused people throughout the country of involvement in this scheme. The DOJ has reported arrests connected to this take-down in states that include California, Florida, Texas, Michigan, Illinois, Louisiana, Tennessee, Maine, Vermont and New York. 13 individuals in New York face charges of kickbacks and services not rendered leading to an alleged $38 million fraudulent billings.

The DOJ reported the arrested individuals include 76 physicians along with an additional 86 nurses and other medical professionals. Accusations of involvement in this type of scheme are serious. It is often wise to take proactive action when an accusation escalates to an investigation by the DOJ, Medicaid Fraud Control Unit or Federal Bureau of Investigation (FBI). An attorney experienced in representing medical providers in these situations can help.