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DOJ pursues healthcare fraud case, alleges billions in violations

The Department of Justice (DOJ) released the federal indictments for a group of individuals charged in one of the largest cases of healthcare fraud in recent history. The case is the result of a joint operation involving many agencies including the Federal Bureau of Investigation, U.S. Department of Health and Human Services Office of Inspector General and the Internal Revenue Service Criminal Investigation as well as various state agencies throughout the country.

Details of the allegations: The prosecution states durable medical equipment (DME) companies paid illegal kickbacks in exchange for the referral of Medicare beneficiaries. The company would then provide the beneficiaries with medically unnecessary knee, back or shoulder braces. According to the indictment, the defendants paid physicians to prescribe the braces either without patient contact or after a brief phone conversation.

The government further alleges the practice crossed borders, making use of call centers operating out of the Philippines and locations in Latin America.

More on the accused: The government has filed criminal charges against 24 individuals, including chief executive officers, chief operating officers and other business leaders operating telemedicine facilities as well as physicians. The allegations include over $1.7 billion in claims.

Lesson for medical professionals: The case is another example of the government’s continued efforts to crackdown on healthcare fraud. Business leaders and medical professionals that become the subject of a government investigation are wise to protect their interests. An attorney experienced in allegations of healthcare fraud can help build a defense and better ensure your rights are protected.