Attorney General Jeff Sessions must really like the new Parliament album. On Thursday he proudly declared himself top “Medicaid Fraud Dogg,” when he announced the Justice Department’s “historic” roundup of 601 doctors, nurses and other licensed medical professionals, in a $2 billion bust. “We’re just getting started,” Sessions promised.
In one typical case, the owner of a sober living center, along with the medical director and two employees, “illegally recruited patients, paid kickbacks and defrauded health care benefit programs for widespread fraudulent urine testing. During the course of the fraudulent scheme, the facility submitted more than $106 million in claims for substance abuse treatment services.”
Apparently, all you needed to do to get rich under Obama was defraud the massive government healthcare system.
Another “drug and money laundering conspiracy” involved “fraudulent prescriptions to fill bulk orders for over one million pills of hydrocodone and oxycodone, which the pharmacy, in turn, sold to drug couriers for millions of dollars.”
A third fraud racket highlights how “an attorney/marketer paid kickbacks and offered incentives such as prostitutes and expensive meals to two podiatrists in exchange for prescriptions written on pre-printed prescription pads.” After getting the prescriptions filled, “members of the conspiracy submitted approximately $250 million in fraudulent claims to federal, state, and private insurers for the compounded drugs.”
In Brooklyn, the owner of a medical van transport company “was charged in a $7 million conspiracy stemming from the alleged payment of kickbacks for the referral of patients, who subjected themselves to purported physical and occupational therapy and other services, and were transported by the ambulette company.”
“Today the Department of Justice is announcing the largest health care fraud enforcement action in American history. This is the most fraud, the most defendants, and the most doctors ever charged in a single operation… We have evidence that our ongoing work has stopped or prevented billions of dollars’ worth of fraud.”
The huge number of arrests will have an enormous effect because “virtually every health care fraud scheme requires a corrupt medical professional to be involved in order for Medicare or Medicaid to pay the fraudulent claims,” the statement released by the DOJ explains.
“Aggressively pursuing corrupt medical professionals not only has a deterrent effect on other medical professionals but also ensures that their licenses can no longer be used to bilk the system.”
Before the big bust, Health and Human Services had already “excluded 2,700 individuals from participation in Medicare, Medicaid, and all other Federal health care programs.”
The Attorney General had especially harsh words for the 200 professionals “accused of playing a role in the nation’s opioid epidemic. America will no longer be what George Clinton calls, “one nation under sedation.”
“Some of our most trusted medical professionals look at their patients, vulnerable people suffering from addiction, and they see dollar signs. That is a fact. It’s painful but true and some of these cases prove it, without a doubt.”
“These kinds of scams undercut the confidence and trust of the American people in federal health care programs,” Health and Human Services Secretary Alex Azar mentioned. “The perpetrators really are despicable and greedy people.” First, they give you the disease, then they can give you the cure.
One Dr. Feelgood was “accused of distributing more than 2 million unnecessary doses of drugs like Fentanyl.” That’s why Sessions also created a brand new “Opioid Fraud and Abuse Detection Unit” to monitor professionals who abuse the system.
At the press conference, Sessions noted that not only are vulnerable patients betrayed, the taxpayers are being robbed. “Every dollar recovered in this year’s operation represents not just a taxpayer’s hard-earned money—it’s a dollar that can go toward providing healthcare for Americans in need,” Secretary Azar added.
“In many cases, doctors, nurses, and pharmacists take advantage of people suffering from drug addiction in order to line their pockets,” AG Sessions states. “These are despicable crimes.”
The DOJ has recently hired a lot more prosecutors and now will be “leveraging the power of data analytics.”
Most of the schemes involve people who recruit patients, the patients themselves, and “other co-conspirators” who were given cash payment “kickbacks.” “Beneficiary information” is worth its weight in gold.
Deputy Director of the Federal Bureau of Investigation, David Bowdich, emphasizes that money isn’t the only thing at stake. “Healthcare fraud touches every corner of the United States and not only costs taxpayers money, but also can have deadly consequences.”
“Through investigations across the country,” Bowdich says, “we have seen medical professionals putting greed above their patients’ well-being and trusted doctors fanning the flames of the opioid crisis.”
Even the Internal Revenue Service was involved in the raids. Deputy Chief Eric Hylton of the IRS-OIG took a turn at the podium. “It takes a special kind of person to prey on the sick and vulnerable as happened in many of these health care fraud schemes,” he remarked. “Medical professionals and others callously placed individuals and vital healthcare services in harm’s way simply because of greed.”
“Investigations that culminated in enforcement actions over the past several days underscore the steadfast commitment of the Defense Criminal Investigative Service and our investigative partners to vigorously investigate fraud impacting TRICARE. We remain vigilant in our efforts to ensure the high standards of care our service members, military retirees, and their dependents deserve while safeguarding American taxpayer dollars.”
Thirty separate “Medicaid Fraud Control Units” from various states took part in the dragnet, which was “led and coordinated by the Criminal Division, Fraud Section’s Health Care Fraud Unit in conjunction with its Medicare Fraud Strike Force partners, a partnership between the Criminal Division, U.S. Attorney’s Offices, the FBI and HHS-OIG.” Numerous other agencies played a role as well.