Attorney General Jeff Sessions announced Thursday that 412 people — including 115 doctors and other health care providers — have been charged in health care fraud schemes resulting in $1.3 billion in “false billings.”
Calling the investigation the “largest health care fraud takedown operation in American history,” Sessions, joined by Health and Human Services Secretary Tom Price and FBI Acting Director Andrew McCabe, said the operation targeted health care providers accused of fraudulent billing for unnecessary prescriptions and medications that often never made it to the beneficiaries.
Nearly a third of the charges announced Thursday are related to drugs. Some 120 defendants were charged in connection with “prescribing and distributing opioids and other dangerous narcotics.”
One group of six doctors in Michigan is alleged to have provided patients with unnecessary opioids and billed Medicare for $164 million in false and fraudulent claims, according to Sessions. Another group, in Houston, allegedly gave out prescriptions for cash.
The attorney general also referenced a fake rehab facility in Palm Beach that he said billed patients more than $58 million in false treatments and tests.
According to Sessions, 295 health care providers are now in the process of being suspended or banned from participation in federal health programs.
“These people inflicted a special kind of damage,” McCabe said. “They not only defrauded Medicare, Medicaid and TRICARE out of many millions of taxpayer dollars — they preyed on the vulnerable.”
Sessions, Price, McCabe and others emphasized the scale of the opioid epidemic, which they said takes more than 90 lives a day.
“One American dies of a drug overdose every 11 minutes, and more than 2 million Americans are ensnared in addiction to prescription painkillers,” Sessions said.
One in every three Medicare beneficiaries received a prescription opioid in 2016, amounting to over $4 billion, Price said.
To help curb the nation’s opioid overdose epidemic, US Food and Drug Administration Commissioner Scott Gottlieb expanded its requirements Monday for prescription opioid manufacturers to provide prescriber training to clinicians, including nurses, pharmacists and physicians.
The overall number of opioid prescriptions, however, decreased 18% from 2010 to 2015 — a year with 33,000 reported opioid-related deaths across the nation, according to a Center for Disease Control report July 7.
The takedown — now in its eighth year — is being led by the DOJ’s Criminal Division, US Attorneys’ Offices, HHS and more than 1,000 state and federal law enforcement agents, according to Sessions.
The news comes the same day as Senate Republicans are expected to release publicly a new version of their health care proposal. The current bill, however, has received criticism for ending the Affordable Care Act requirement that addiction services and mental health treatment be covered under Medicaid in the 31 states that expanded the health care program.
