Crushing Bad Medicine: 2017 Nationwide Health Care Fraud Takedown


A nationwide sweep that began with tips from consumers resulted in what federal officials are calling “the largest-ever health care fraud enforcement action” by the Medicare Fraud Strike Force.

The 2017 National Health Care Fraud Takedown, which occurred this month, was a nationwide sweep involving more than 1,000 law enforcement agents in at least 30 states. Four hundred and twelve individuals were arrested in the sweep for crimes that totaled $1.3 billion in false billings, including prescribing and distributing opioids and other dangerous narcotics.

California was one of the 30 states involved in the crackdown. A joint effort between 17 state and federal agencies—including the California State Board of Pharmacy—resulted in the charging of 14 defendants in the Central District of California for allegedly participating in health care fraud schemes that resulted in approximately $147 million in losses.

Some of the California cases include:

  • A physician indicted by a federal grand jury on 34 counts of illegally prescribing controlled drugs, including oxycodone, and one count of false statement on a DEA registration application. He allegedly sold more than 1.2 million pills of narcotics, in addition to hundreds of thousands of pills of other controlled drugs such as the sedatives Xanax and Soma, to addicts in other states.
  • A physician indicted for allegedly authorizing prescriptions for compounded medications for patients he never examined.
  • A Southern California acupuncturist charged on June 22 with eight counts of health care fraud and three counts of money laundering.
  • A pharmacist charged with health care fraud related to his pharmacy processing and billing TRICARE for approximately $62 million for fraudulent prescriptions for compounded medications.

“Health care fraud schemes such as these threaten the vital trust between a patient and his or her health care provider, undermine the integrity of our health care system, and cost all Americans billions of dollars,” said Acting United States Attorney Sandra R. Brown.

Although the sweep netted its share of individuals committing health care fraud, officials at the Department of Justice stated the main focus of the investigation was on medical professionals who were involved in the unlawful distribution of opioids and other prescription narcotics. According to the Centers for Disease Control and Prevention, approximately 91 Americans die every day of an opioid- elated overdose.

 

 

 

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