In a recent announcement, the Department of Justice (DOJ) revealed that it has brought charges against 78 individuals involved in separate healthcare fraud and opioid abuse schemes, totaling $2.5 billion. These defendants are accused of defrauding programs designed to assist elderly and disabled individuals, with some of the ill-gotten funds being used to purchase luxury items such as exotic cars, jewelry, and yachts. The charges span 16 states and include fraudulent claims made through telemedicine and prescription drug fraud. This coordinated crackdown represents an intensified effort by the DOJ to combat fraud and hold accountable those who profit from it.
Among the defendants, 11 individuals are accused of submitting $2 billion in fraudulent claims through telemedicine, while 10 defendants are charged in connection with fraudulent prescription drug claims. The alleged perpetrators include physicians and other licensed medical professionals who exploited their positions for personal gain. Some doctors are accused of providing opioids to patients who did not require them, thereby putting their well-being at risk.
The Massive Healthcare Fraud Scheme:
Attorney General Merrick Garland highlighted one of the largest healthcare fraud schemes ever prosecuted by the DOJ. This scheme involved executives of purported software and services companies who submitted $1.9 billion in fraudulent claims to Medicare for items that were ineligible for reimbursement. The indictment alleges that Brett Blackman and Gregory Schreck from Johnson County, Kansas, and Gary Cox from Maricopa County, Arizona, employed mass telemarketing operations to sell expensive and unnecessary medical equipment and prescriptions to the elderly and disabled.
They operated a software platform called DMERx, which generated fake doctors’ orders in exchange for illegal kickbacks and bribes. The defendants received payments for referring fraudulent orders and prescriptions to pharmacies, suppliers, and telemarketers. The scheme involved falsely claiming that the doctors had examined or treated the patients when, in reality, minimal or no interaction occurred.
Additional Cases of Fraud:
In another case, Steven Diamantstein, owner of Scripts Wholesale Inc., was indicted for a $150 million fraud scheme involving HIV medication. Diamantstein allegedly obtained HIV drugs at a discounted rate from individuals who illegally acquired the pills by offering cash payments to patients and then repackaging them for sale. He falsely represented that his company had obtained the drugs through legal channels.
Furthermore, the DOJ charged 24 doctors and medical professionals in cases related to $150 million in false billings associated with the illegal distribution of opioids and lab testing fraud.
The Department of Justice‘s recent announcement of charges against 78 individuals involved in healthcare fraud and opioid abuse schemes demonstrates a commitment to combatting fraudulent practices and prosecuting those responsible. These cases expose the exploitation of programs meant to provide care for vulnerable populations, emphasizing the need for robust measures to prevent and detect such schemes. As authorities continue their efforts to safeguard the integrity of the healthcare system, it is hoped that these actions will serve as a deterrent and ensure that those who profit from fraudulent activities face the consequences of their actions.