WASHINGTON — Nearly 200 people have been charged in a sweeping nationwide crackdown on health care fraud schemes with false claims topping $2.7 billion, the Justice Department said on Thursday.
Attorney General Merrick Garland announced the charges against doctors, nurse practitioners and others across the U.S. accused of a variety of scams, including a $900 million scheme in Arizona targeting dying patients.
“It does not matter if you are a trafficker in a drug cartel or a corporate executive or medical professional employed by a health care company, if you profit from the unlawful distribution of controlled substances, you will be held accountable,” Garland said in a statement.
In the Arizona case, prosecutors have accused two owners of wound care companies of accepting more than $330 million in kickbacks as part of a scheme to fraudulently bill Medicare for amniotic wound grafts, which are dressings to help heal wounds.
Nurse practitioners were pressured to apply the wound grafts to elderly patients who didn’t need them, including people in hospice care, the Justice Department said. Some patients died the day they received the grafts or within days, court papers say.
In less than two years, more than $900 million in bogus claims were submitted to Medicare for grafts that were used on fewer than 500 patients, prosecutors said.
The owners of the wound care companies, Alexandra Gehrke and Jeffrey King, were arrested this month at the Phoenix airport as they were boarding a flight to London, according to court papers urging a judge to keep them behind bars while they await trial. An attorney for Gehrke declined to comment, and a lawyer for King didn’t immediately respond to an email from The Associated Press.
Authorities allege Gehrke and King, who got married this year, knew charges were coming and had been preparing to flee. At their home, authorities found a book titled “How To Disappear: Erase Your Digital Footprint, Leave False Trails, and Vanish Without a Trace,” according to court papers. In one of their bags packed for their flight, there was a book titled “Criminal Law Handbook: Know Your Rights, Survive The System,” the papers say.
Gehrke and King lived lavishly off the scheme, prosecutors allege, citing in court papers luxury cars, a nearly $6 million home and more than $520,000 in gold bars, coins and jewelry. Officials seized more than $52 million from Gehrke’s personal and business bank accounts after her arrest, prosecutors say.
In total, 193 people were charged in a series of separate cases brought over about two weeks in the nationwide health care fraud sweep. Authorities seized more than $230 million in cash, luxury cars and other assets. The Justice Department carries out these sweeping health care fraud efforts periodically with the goal of helping to deter other potential wrongdoers.
In another Arizona case, one woman is accused of billing the state’s Medicaid agency for substance abuse treatment services that didn’t serve any real purpose or were never provided, prosecutors say.
Another case alleges a scheme in Florida to distribute misbranded HIV drugs. Prosecutors say drugs were bought on the black market and resold to unsuspecting pharmacies, which then provided the medications to patients.
In some cases, patients were given bottles that contained different drugs than the label showed. One patient ended up unconscious for 24 hours after taking what he was led to believe was his HIV medication but was actually an anti-psychotic drug, prosecutors say.
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The Department of Justice (DOJ) has recently announced charges against nearly 200 individuals in a massive crackdown on health care fraud. The charges are part of a coordinated effort to combat fraud in the health care industry, which costs the government billions of dollars each year.
The DOJ’s investigation targeted individuals and companies involved in a wide range of fraudulent activities, including billing for services that were never provided, submitting false claims for reimbursement, and paying kickbacks to doctors and patients in exchange for referrals. The fraud schemes uncovered by the DOJ are estimated to have cost the government over $2.7 billion in losses.
Health care fraud is a serious problem that not only drains valuable resources from the government but also puts patients at risk. When providers engage in fraudulent activities, they may be providing substandard care or unnecessary treatments in order to maximize their profits. This can have serious consequences for patients, who may receive treatments that are not medically necessary or even harmful.
The DOJ’s crackdown on health care fraud is an important step in protecting patients and taxpayers from unscrupulous providers. By holding individuals and companies accountable for their fraudulent activities, the DOJ is sending a clear message that fraud will not be tolerated in the health care industry.
In addition to prosecuting individuals and companies involved in health care fraud, the DOJ is also working to prevent fraud before it occurs. The department has established a number of initiatives aimed at detecting and deterring fraudulent activities in the health care industry, including increased oversight and monitoring of billing practices, as well as partnerships with other government agencies and private sector organizations.
The DOJ’s efforts to combat health care fraud are an important part of its broader mission to protect the integrity of the health care system and ensure that patients receive high-quality care. By holding fraudsters accountable and implementing measures to prevent fraud in the future, the DOJ is working to safeguard the health and well-being of all Americans.
