The Department of Justice announced it has charged 450 defendants for alleged healthcare fraud totaling $6.5 billion.
“Since June 8, we’ve charged 455 defendants across 56, like I said a minute ago, US attorney’s offices and 45 US states and territories, as alleged in the various indictments,” said acting Attorney General Todd Blanche. “These individuals participated in healthcare fraud schemes involving over $6.5 billion in false claims submitted to Medicare, Medicaid, and other health care programs.”
Blanche described one alleged fraud scheme involving wound care:
The defendants allegedly used the money to live a luxury lifestyle:
“The coordinated actions of the past two weeks have resulted in over $182 million in cash and other assets seized, making clear our health care fraud enforcement efforts generate a significant return on investment for our taxpayers,” added Blanche.
Several Los Angeles healthcare businesses face charges, including four hospices that bribed and provided items to enroll people who were not terminal. The owners allegedly made $27.7 million in Medicare claims, receiving $26l.9 million:
According to the indictment, prosecutors allege the scheme involved enrolling deceased Medicare beneficiaries in hospice after their deaths using stolen personal information obtained through a funeral home employee, and creating backdated medical records to make it appear the patients had qualified for hospice before they died.The owner of the hospices, Oren David Shachar, also personally approached Medicare beneficiaries, according to the indictment, misrepresented hospice as a program focused on improving quality of life rather than end-of-life care, and concealed that enrolling in hospice would limit their access to other Medicare-covered treatments. The indictment further alleges that the owner paid beneficiaries up to $400 a month in cash and provided groceries, alcohol, televisions, furniture and other gifts to keep them enrolled, while also offering referral payments to beneficiaries who recruited others into the program.
The FBI arrested 11 people in California accused of hospice fraud in April.
“This is the second largest amount ever charged in a single healthcare fraud operation,” HHS Secretary Robert F Kennedy Jr. told the press. “Every fraudulent dollar diverted into a criminal scheme is a dollar unavailable for patient care, for medical innovation, or for services for vulnerable Americans.”
Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz laid out two important cases:
Oz mentioned that the fraud team identified these cases using tools that previous administrations rarely used.
“We use administrative muscle to push things through, and we are closing loopholes that fraudsters have avoided and been exploiting for years,” stated Oz. “Those days are over.”
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