Sixty people in Florida were among 324 charged nationwide in what the Justice Department is calling the nation’s largest coordinated takedown of health care schemes.
Law enforcement at the state and federal level seized more than $245 million in cash, luxury vehicles, cryptocurrency, and other assets as prosecutors warned of a growing push by transnational criminal networks to exploit the U.S. health care system.
Those charged include 96 doctors, nurse practitioners, pharmacists, and other licensed medical professionals for their participation in fraud involving over $14.6 billion in intended loss, more than twice the previous record in the DOJ’s annual health care fraud crackdown.
In Florida, federal charges were filed in 41 cases against defendants in connection with alleged schemes to unlawfully distribute controlled substances and defraud federal health care programs, including Medicare and Medicaid, the state’s U.S. Attorney offices reported.
As part of the sweeping crackdown, DOJ officials identified perpetrators based in Russia, Eastern Europe, Pakistan, and other countries.
“These criminals didn’t just steal someone else’s money. They stole from you,” Matthew Galeotti, who leads the Justice Department’s criminal division said Monday when announcing the arrests. “Every fraudulent claim, every fake billing, every kickback scheme represents money taken directly from the pockets of American taxpayers who fund these essential programs through their hard work and sacrifice.”
The crackdown includes nearly 190 federal cases and more than 90 state cases that have been charged or unsealed since June 9. Nearly 100 licensed medical professionals were charged, including 25 doctors, and the government reported $2.9 billion in actual losses.
Among the cases is a $10 billion urinary catheter scheme that authorities say highlights the increasingly sophisticated methods used by transnational criminal organizations. Authorities say the group behind the scheme used foreign straw owners to secretly buy up dozens of medical supply companies and then used stolen identities and confidential health data to file fake Medicare claims.
Nineteen defendants have been charged as part of that investigation — which authorities dubbed Operation Gold Rush — including four people arrested in Estonia and seven people arrested at U.S. airports and at the border with Mexico, prosecutors said. The scheme involved the stolen identities and personal information of more one million Americans, according to the Justice Department.
In another investigation, a Pakistani national is accused of orchestrating a $650 million fraud scheme that primarily targeted an Arizona Medicaid program offering addiction treatment and other services for Native Americans.
Court papers say the defendant, Farrukh Ali, conspired with at least 41 substance abuse clinics to bill the state for hundreds of millions of dollars for substance abuse services that were never provided, not provided as billed or were medically unnecessary. Many of the patients who were enrolled — but not given legitimate treatment — were recruited from the homeless population or Native American reservations, officials say.
“It’s not done by small time operators,” said Dr. Mehmet Oz, who leads the Centers for Medicare and Medicaid Services. “These are organized syndicates who are designing to hurt America.”
The effort is part of the department's long-running campaign to combat fraud in the health care sector, which officials estimate at around $300 billion per year.