Fraud and Compliance Update
The Department of Justice (DOJ) announced that coordinated health care fraud enforcement action across seven federal districts in the Northeastern United States, involving more than $800 million in loss and the distribution of over 3.25 million opioids through “pill mill” clinics, resulted in new charges against 48 defendants.
Defendants include 15 doctors or medical professionals and 24 who were charged for their roles in diverting opioids, DOJ said.
According to DOJ, the enforcement action also includes the guilty pleas of three previously charged corporate executives, including the Vice President of Marketing of numerous telemedicine companies and two owners of approximately 25 durable medical equipment companies, for their roles in causing the submission of over $600 million in fraudulent claims to Medicare.
The charges and guilty pleas reflect targeted enforcement of corporate health care fraud involving fraudulent telemedicine companies; the solicitation of illegal kickbacks and bribes from health care suppliers in exchange for the referral of Medicare beneficiaries for medically unnecessary durable medical equipment and other testing; and of individuals contributing to the opioid epidemic, including medical professionals involved in the unlawful distribution of opioids and other prescription narcotics, DOJ said.
Charges contained in indictments are allegations only; all defendants are presumed innocent until proven guilty.