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193 individuals are facing charges from the Justice Department for $2.8 billion in healthcare fraud.

Attorney General Merrick Garland announced the start of a two-week investigation on Thursday, accusing 193 individuals nationwide, including 76 certified healthcare providers, of participating in healthcare fraud schemes.

The Department of Justice (DOJ) highlighted 145 incidents, which Garland claims had intentional losses exceeding $2.75 billion and actual losses of $1.6 billion. The Department of Justice exposed allegations of medically unnecessary amniotic wound grafts, misappropriated HIV drugs, online Adderall distribution, and other telemedicine operations.

According to Garland, “the Justice Department’s investigative and prosecuting techniques will develop as healthcare fraud schemes do.” “We have a clear message for anyone looking to take advantage of people and cheat government programs: you cannot hide your crimes. We’ll track you down and make sure you answer for your actions.

The Criminal Division’s Health Care Fraud Unit, Federal, worked with many state and federal law enforcement agencies, including the FBI, the Drug Enforcement Administration, and the Office of Inspector General (HHS-OIG) of the Department of Health and Human Services.

The government stated that it was able to take more than $231 million in “cash, luxury vehicles, gold, and other assets,” in addition to convictions in 32 federal districts and 11 states.

The Centers for Medicare & Medicaid Services Administrator, Chiquita Brooks-LaSure, added in a statement that her agency “took 127 administrative actions in the last six months independently against providers for their alleged involvement in healthcare fraud schemes.”

A fraud operation worth over $900 million, in which four defendants allegedly preyed on elderly Medicare patients for costly amniotic grafts, was law enforcement’s top focus. The Department of Justice released a statement stating that the patients’ superficial wounds received these therapies “indiscriminately, without coordination with the patient’s treating physicians, and without necessary treatment for infection.”

Two of those defendants allegedly earned more than $600 million from Medicare in just 16 months, according to the DOJ.

Another action that the authorities detailed involved three owners and executives of a wholesale drug distributor. Law enforcement charged these individuals with participating in a $90 million wire fraud scheme using “adulterated and misbranded HIV drugs,” which they allegedly fraudulently recovered from patients and resold to pharmacies around the country.

The DOJ stated that “sometimes, patients received bottles labeled as their prescription medication, but the bottles contained a different substance entirely.” One patient, believing that he was receiving an antipsychotic drug, passed out and remained comatose for 24 hours.

Additionally, the government underscored the allegations previously made public against the clinical president and CEO of the telehealth firm Done, alleging that they orchestrated the prescription of 40 million stimulant drugs, including Adderall, on behalf of the company.

The latest statement made reference to new charges against their associates, one of whom is a Florida nurse practitioner who, according to the DOJ, wrote prescriptions for more than 1.5 million drugs without first consulting patients.

Done has issued a statement expressing its “disagreement” with the charges levied against its leadership, and it plans to continue operating normally.

FBI Director Christopher Wray stated in a statement that “Healthcare fraud plunders healthcare programs, endangers the health of vulnerable people, and victimizes patients.” “The FBI is committed to exposing predatory healthcare fraud, safeguarding patients, and making sure vital healthcare funding reaches the places where it is most needed,” as this extensive partnership illustrates.

Author: Steven Sinclaire

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