87 In Florida Charged In National Health Care Fraud Crackdown

Jul 14, 2017

More than 80 people in Florida were charged in a nationwide crackdown on health care fraud and opioid scams that totaled $1.3 billion in falls billings, according to a release from the U.S. Department of Justice.

The action, which involved law enforcement agencies throughout the country and resulted in 400 arrests, was called the "largest health care fraud takedown operation in American history" by Attorney General Jeff Sessions. Sessions said it indicates that some doctors, nurses and pharmacists "have chosen to violate their oaths and put greed ahead of their patients."

In the Southern District of Florida, 77 defendants were charged in fraud schemes that totaled $141 million in false billings for home health care services, mental health services and pharmacy fraud.

One case involved the owner of an addiction treatment center and home for recovering addicts. The owner and another individual were charged with submitting more than $58 million in fake insurance claims for treatment.

According to the Department of Justice, the suspects recruited people who where were addicted to drugs to move to South Florida. They would then bill insurance companies for fraudulent treatments. In exchange, the suspects would give the addicts gift cards, free airline travel, trips to casinos and strip clubs and drugs, the justice department said.

Ten people were charged in the Middle District of Florida with schemes that involved nearly $14 million in false charges, according to the Department of Justice.

One of those defendants misrepresented himself as a retired Lieutenant Commander of the U.S. Navy to gain the trust from TRICARE beneficiaries in order to steal their personal identities, the justice department said. Many TRICARE beneficiaries are members and veterans of the armed forces. The suspect and two others were charged with trying to defraud the TRICARE program of $4 million.

Of those charged nationally, more than 120 people were involved in illegally prescribing and distributing narcotic painkillers. Such prescription opioids are behind the deadliest drug overdose epidemic in U.S. history. More than 52,000 Americans died of overdoses in 2015 — a record — and experts believe the numbers have continued to rise.

"In some cases, we had addicts packed into standing-room-only waiting rooms waiting for these prescriptions," acting FBI director Andrew McCabe said. "They are a death sentence, plain and simple."

Nearly 300 health care providers are being suspended or banned from participating in federal health care programs, Sessions said.

"They seem oblivious to the disastrous consequences of their greed. Their actions not only enrich themselves, often at the expense of taxpayers, but also feed addictions and cause addictions to start," Sessions said.

Health care fraud sweeps happen each year across the country, but law enforcement officials continue to grapple over the best way to fight the problem.

The people charged were illegally billing Medicare, Medicaid and the health insurance program that serves members of the armed forces, retired service members and their families, the Justice Department said. The allegations include claims that those charged billed the programs for unnecessary drugs that were never purchased or given to the patients.