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Rabbitt of the Justice Department\u2019s Criminal Division, Assistant Director Calvin Shivers of the FBI\u2019s Criminal Investigative Division, Deputy Inspector General Gary Cantrell of the Department of Health and Human Services Office of Inspector General (HHS-OIG) and Assistant Administrator Tim McDermott of the Drug Enforcement Administration (DEA) today announced a historic nationwide enforcement action involving 345 charged defendants across 51 federal districts, including more than 100 doctors, nurses, and other licensed medical professionals.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EThese defendants have been charged with submitting more than $6 billion in false and fraudulent claims to federal health care programs and private insurers, including more than $4.5 billion connected to telemedicine, more than $845 million connected to substance abuse treatment facilities, or \u201csober homes,\u201d and more than $806 million connected to other health care fraud and illegal opioid distribution schemes across the country.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EToday\u2019s enforcement actions were led and coordinated by the Criminal Division, Fraud Section\u2019s Health Care Fraud Unit, in conjunction with its Health Care Fraud and Appalachian Regional Prescription Opioid (ARPO) Strike Force program, and its core partners, the U.S. Attorneys\u2019 Offices, HHS-OIG, FBI, and DEA, as part of the department\u2019s ongoing efforts to combat the devastating effects of health care fraud and the opioid epidemic.\u0026nbsp;The cases announced today are being prosecuted by Health Care Fraud and ARPO Strike Force teams from the Criminal Division\u2019s Fraud Section, along with 43 U.S. Attorneys\u2019 Offices nationwide, and agents from HHS-OIG, FBI, DEA, and other various federal and state law enforcement agencies.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EPrior to the charges announced as part of today\u2019s nationwide enforcement action and since its inception in March 2007, the Health Care Fraud Strike Force program had charged more than 4,200 defendants who have collectively billed the Medicare program for approximately $19 billion.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EThe Middle District of Florida (MDFL) is playing a significant role in today\u2019s historic announcement. Collaborative efforts among federal, state, and local partners have resulting in charges against 19 defendants in the MDFL.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cPatients place their lives in the hands of medical professionals every day,\u201d said U.S. Attorney Maria Chapa Lopez for the Middle District of Florida. In doing so, they rely upon the oath that they will put forth their best efforts to do no harm. Not only is fraud and abuse of healthcare programs illegal, but they compromise the standard of care and the public trust. We will continue to aggressively investigate these claims and hold those who violate the law accountable by all means.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u0022The FBI and its law enforcement partners are determined to expose those who commit healthcare fraud.\u0022 said Special Agent in Charge of FBI Tampa Division Michael F. McPherson. \u0022We are all victims of this crime when federal healthcare programs that taxpayers fund are cheated.\u0022\u003C\/p\u003E\n\n\u003Cp\u003E\u201cWe will continue to hold medical professionals accountable for the great responsibility with which they have been entrusted, said Omar P\u00e9rez Aybar, Special Agent in Charge of the Department of Health and Human Services, Office of Inspector General. \u201cThere are no shortcuts when it comes to patient care.\u201d\u003C\/p\u003E\n\n\u003Cp\u003EDavid Spilker, Special Agent in Charge at the VA Office of Inspector General stated, \u201cThe continued oversight of medical professionals who provide community care to veterans\u2014our nation\u2019s heroes\u2014safeguards the integrity of VA\u2019s healthcare programs. The VA OIG will continue to work with our law enforcement partners to hold providers who fraudulently bill CHAMPVA responsible for their unlawful conduct.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u0022Unfettered greed erodes public trust, stifles our economy, and hurts hard-working Americans,\u0022 stated Special Agent in Charge Brian Payne of IRS Criminal Investigation\u0027s Tampa Field Office.\u0026nbsp; \u0022Working with our law enforcement partners, we will fervently employ our unique financial investigative skills to lead the fight against white collar crime.\u0022\u003C\/p\u003E\n\n\u003Cp\u003E\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003E\u003Cu\u003EHEALTH CARE FRAUD CASES\u003C\/u\u003E\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe MDFL health care fraud cases included in today\u2019s announcement involve charges brought against 12 defendants for health care fraud and violations of the federal Anti-Kickback statute. These defendants have been charged with submitting hundreds of millions of dollars in false and fraudulent claims to Medicare and other federal health care programs and employing abusive schemes that often involved telemedicine.\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EAll of the MDFL cases described in this section are being investigated by various agencies, including the U.S. Department of Health and Human Services\u2013Office of Inspector General, the Federal Bureau of Investigation,\u0026nbsp;the Department of Veterans Affairs\u2013Office of Inspector General, and the Internal Revenue Service Criminal Investigation.\u003C\/p\u003E\n\n\u003Cp\u003EIn September 2020,\u003Cb\u003E Charles Burruss \u003C\/b\u003E(51, San Diego, CA) and \u003Cb\u003EArdalaan \u201cArmani\u201d Adams (\u003C\/b\u003E33, San Diego, CA) were charged with conspiracy for defrauding Medicare through the submission of medically unnecessary durable medical equipment (\u201cDME\u201d) claims. According to court documents, Adams and Burruss paid millions in kickbacks and bribes to acquire the DME claims, which had been generated using aggressive telemarketing strategies in concert with fraudulent telemedicine involving bribed doctors who rarely spoke to the beneficiaries. During the conspiracy, Burruss, Adams, and their conspirators submitted the illegal DME claims to Medicare and other programs through a conglomerate of fraudulently established DME companies; at least 22 of those fraudulent companies were located in the MDFL. Through the MDFL companies, the conspirators submitted more than $343 million in illegal DME claims to Medicare and to the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), resulting in over $180 million in payments. The defendants have also been charged in related cases in the Southern District of California and the District of New Jersey. Each defendant faces a collective maximum penalty of 25 years\u2019 imprisonment, if imposed consecutively, for the pending charges. The MDFL case is being prosecuted by Assistant United States Attorney Kristen Fiore.\u003C\/p\u003E\n\n\u003Cp\u003EOn July 31, 2020, \u003Cb\u003ERichard Epstein\u003C\/b\u003E (28, Aurora, CO) and \u003Cb\u003EMichael Nolan\u003C\/b\u003E (47, Tampa, FL) each pleaded guilty, in separate cases, to conspiracy to commit health care fraud for defrauding Medicare through the submission of medically unnecessary claims for DME and cancer genetic testing (\u201cCGx testing\u201d). According to court documents, during the conspiracy, Epstein and Nolan ran a telemarketing company in Tampa known as REMN Management, LLC, that targeted the elderly to generate thousands of medically unnecessary orders for DME and CGx testing. The two men also created and operated Comprehensive Telcare, LLC (\u201cCompTel\u201d), a \u201ctelemedicine\u201d company through which they illegally bribed medical practitioners to sign the orders regardless of medical necessity. They then illegally sold the signed orders to client-conspirators for submission to Medicare. The conspiracy resulted in the submission of at least $134 million in fraudulent claims to Medicare and other federal health benefit programs, resulting in approximately $29 million in payments. The defendants are each facing a maximum penalty of 10 years in federal prison. The cases are being prosecuted by Assistant United States Attorney Kristen Fiore and Trial Attorney Gary A. Winters of the DOJ Criminal Division\u2019s Fraud Section.\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003EPaul Savastano\u003C\/b\u003E (49, Lake Worth, FL), who conspired with Epstein and Nolan, also pleaded guilty on July 31, 2020, to health care fraud conspiracy. Savastano\u2019s role in the conspiracy was that of a broker who oversaw CompTel\u2019s illegal delivery of thousands of the signed orders to Medicare-enrolled DME supply companies, including at least five DME companies secretly controlled by Patsy Truglia (charged separately). For his part, Savastano received a percentage of the bribes as his fee. He is facing a maximum penalty of 10 years in federal prison. The case is being prosecuted by Assistant United States Attorney Kristen Fiore.\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003Cb\u003E\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003EIn June 2020, \u003Cb\u003EDr. Jonathan Michael Rouffe\u003C\/b\u003E (47, Boca Raton, FL) and \u003Cb\u003EDr. Richard Davidson\u003C\/b\u003E (41, Delray Beach, FL) pleaded guilty in separate cases to conspiracy to commit health care fraud. Each faces a maximum penalty of 10 years in federal prison. According to court documents, Rouffe, Davidson, and other conspirators secretly controlled conglomerates of fraudulently established DME supply companies. During the conspiracies, the companies submitted more than $31 million in illegal DME claims to Medicare and the CHAMPVA, resulting in over $16 million in payments. The conspirators paid millions in kickbacks and bribes to acquire illegally signed doctors\u2019 orders for DME from so-called \u201cmarketers,\u201d who, for their part, had generated the signed doctors\u2019 orders using aggressive telemarketing strategies in concert with fraudulent telemedicine involving bribed doctors. The cases are being prosecuted by Assistant United States Attorney Kristen A. Fiore.\u0026nbsp;\u003Ci\u003EAdditional details can be found in \u003C\/i\u003E\u003Ca href=\u0022https:\/\/www.justice.gov\/usao-mdfl\/pr\/medical-equipment-company-owner-pleads-guilty-20-million-health-care-fraud-conspiracy\u0022\u003E\u003Ci\u003Epress release\u003C\/i\u003E\u003C\/a\u003E\u003Ci\u003E.\u003C\/i\u003E\u003C\/p\u003E\n\n\u003Cp\u003EIn August 2020,\u003Cb\u003E Sajid \u201cJay\u201d Geronimo\u003C\/b\u003E (41, Buena Park, CA) was charged with conspiracy to commit health care fraud. According to court documents, Geronimo owned a telemarketing company known as Cure Healthcare, Inc. that targeted the Medicare-aged population using offshore call centers that employed aggressive tactics to generate orders for DME supply companies. Cure then packaged this information into the format of doctors\u2019 orders and bribed doctors for their signatures. Once signed, Cure sold the illegally signed doctors\u2019 orders to client-conspirators as support for fraudulent claims submitted to Medicare and CHAMPVA, receiving more than $12 million for these illegal sales. Geronimo is facing a maximum penalty of 10 years in federal prison. The case is being prosecuted by Assistant United States Attorney Kristen A. Fiore.\u003C\/p\u003E\n\n\u003Cp\u003EOn September 4, 2020, \u003Cb\u003ESamuel Friedman\u003C\/b\u003E (45, Land O\u2019 Lakes, FL) was sentenced to four years in federal prison for conspiracy to commit health care fraud. According to court documents, through his telemarketing company SKF Enterprises, LLC, Friedman targeted the Medicare-aged population using offshore call centers that employed aggressive tactics to generate orders for DME. SKF then packaged this information into the format of doctors\u2019 orders and bribed doctors for their signatures. Once signed, SKF sold the fraudulently signed doctors\u2019 orders to client-conspirators as support for fraudulent claims submitted to Medicare and CHAMPVA, receiving more than $3.4 million for these illegal sales. Forfeiture was ordered against his interests in real property and a bank account containing nearly $475,000. Restitution was ordered in the amount of $3.42 million. The case was prosecuted by Assistant United States Attorney Kristen A. Fiore.\u0026nbsp;\u003Ci\u003EAdditional details can be found in \u003C\/i\u003E\u003Ca href=\u0022https:\/\/www.justice.gov\/usao-mdfl\/pr\/owner-fraudulent-telemarketing-company-sentenced-four-years-federal-prison\u0022\u003E\u003Ci\u003Epress release\u003C\/i\u003E\u003C\/a\u003E\u003Ci\u003E. \u003C\/i\u003E\u003C\/p\u003E\n\n\u003Cp\u003EIn September 2020, \u003Cb\u003EChristopher Ryan Helfrich\u003C\/b\u003E (30, Tampa, FL) was charged with conspiracy to commit health care fraud. According to court documents, Helfrich and his conspirators owned a telemarketing operation known as A2B Insurance Solutions LLC. Helfrich also wholly owned another telemarketing company, CRH Holdings, LLC. Through these enterprises, Helfrich and his conspirators targeted the Medicare-aged population using offshore call centers that employed aggressive tactics to generate orders for DME. They then packaged this information into the format of doctors\u2019 orders and bribed doctors for their signatures. Once signed, the conspirators sold the fraudulently signed doctors\u2019 orders to client-conspirators as support for fraudulent claims submitted to Medicare and CHAMPVA, receiving more than $2.2 million for these illegal sales. The case is being prosecuted by Assistant United States Attorney Kristen A. Fiore and DOJ Trial Attorney Catherine Wagner of the Criminal Division\u2019s Fraud Section.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003EPatsy Truglia \u003C\/b\u003E(52, Parkland, FL)\u003Cb\u003E \u003C\/b\u003Eand \u003Cb\u003ERuth Bianca Fernandez\u003C\/b\u003E (37, Lauderhill, FL) were charged in a 13-count indictment alleging a conspiracy to defraud Medicare and to commit health care fraud, submit false statements to Medicare, and violate the federal Anti-Kickback statute, as well as other related charges. The indictment was unsealed with the defendants\u2019 arrests on September 9, 2020. According to the indictment, Truglia and Fernandez conspired to create and submit fraudulent claims to Medicare for medically unnecessary DME, using aggressive telemarketing that targeted Medicare beneficiaries, bogus telemedicine encounters, and signed doctors\u2019 orders secured using illegal bribes and kickbacks. Through the conspiracy, Truglia and Fernandez caused the submission of approximately $25 million of fraudulent claims to Medicare and other federal health care programs, including CHAMPVA, resulting in payments of approximately $10 million from the programs. The case was charged by Assistant U.S. Attorney Kristen Fiore and is being prosecuted by Assistant U.S. Attorney Jay G. Trezevant.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003E\u003Cu\u003EOPIOID FRAUD AND ABUSE DETECTION UNIT CASES\u003C\/u\u003E\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003EAdditional MDFL cases included in today\u2019s announcement involve charges brought against 7 defendants who are being prosecuted by the MDFL Opioid Fraud and Abuse Detection Unit (\u201cOPFAD\u201d), a Department of Justice program created to help combat the devastating opioid crisis that is ravaging families and communities across America and to prosecute individuals who have contributed to the opioid epidemic. OPFAD specifically focuses on opioid-related fraud and abuse by medical and health care professionals who have contributed to the prescription opioid epidemic.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003ERichard De La Cruz\u003C\/b\u003E (55, Jacksonville, FL) pleaded guilty and was sentenced on August 25, 2020, to five years\u2019 probation for making false statements relating to health care matters in connection with writing opioid prescriptions. De La Cruz was also ordered to pay restitution and $42,450 in forfeiture. According to court documents, De La Cruz, a Florida-licensed doctor, failed to conduct in-person evaluations with patients before prescribing opiates, as required by Florida law, and concealed such, when he worked for a Kentucky company that provided in-home primary care for patients. This case was investigated by the HHS-OIG. The case was prosecuted by Assistant U.S. Attorneys Kelley Howard Allen and Greg Pizzo.\u0026nbsp;\u003Ci\u003EAdditional details can be found in \u003C\/i\u003E\u003Ca href=\u0022https:\/\/www.justice.gov\/usao-mdfl\/pr\/florida-doctor-pleads-guilty-false-statement-relating-prescribing-opioids\u0022\u003E\u003Ci\u003Epress release\u003C\/i\u003E\u003C\/a\u003E\u003Ci\u003E. \u003C\/i\u003E\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003EHong Truong\u003C\/b\u003E (60, Dunedin, FL), a licensed pharmacist, pleaded guilty to one count of distributing and dispensing a controlled substance outside the scope of professional practice.She was sentenced on September 23, 2020, to 30 months in federal prison, fined $500,000, and ordered to forfeit $766,819 in illegal drug proceeds. According to court documents, Truong owned and operated HP Pharmacy in Pinellas Park, where she dispensed Schedule II controlled substance prescriptions outside the usual course of professional practice, that were not issued for a legitimate medical purpose, and without resolving several red flags. Truong and the pharmacy tech she employed, \u003Cb\u003EJessica Evans \u003C\/b\u003E(34, St. Petersburg, Florida), falsely noted on the back of many prescriptions that the prescription had been verified with the prescriber\u2019s office, when such was not the case. Evans also pleaded guilty for her role in filling the illegal opiate prescriptions and was sentenced on August 27, 2020, to 25 months in federal prison. Also charged in connection with filling false prescriptions at HP Pharmacy were \u003Cb\u003ELucretia Mullan \u003C\/b\u003E(35, St. Petersburg, FL) and \u003Cb\u003EPatrice Jackson\u003C\/b\u003E (37, Bradenton, FL) who were sentenced last summer to federal prison terms of 20 months and 70 months, respectively. This case is being investigated by the Drug Enforcement Administration. The case was prosecuted by Assistant U.S. Attorneys Kelley Howard Allen and Greg Pizzo. \u003Ci\u003EAdditional details can be found in \u003C\/i\u003E\u003Ca href=\u0022https:\/\/www.justice.gov\/usao-mdfl\/pr\/local-pharmacist-sentenced-prison-unlawful-distribution-oxycodone\u0022\u003E\u003Ci\u003Epress release\u003C\/i\u003E\u003C\/a\u003E\u003Ci\u003E. \u003C\/i\u003E\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003ESteven Chun\u003C\/b\u003E (57, Sarasota, FL) and \u003Cb\u003EDaniel Tondre\u003C\/b\u003E (50, Tampa, FL) were charged in a 16-count indictment unsealed on September 16, 2020. According to the indictment, Chun owned and operated a Sarasota pain management practice where he prescribed Subsys, a highly addictive and expensive fentanyl spray, to his patients in return for kickbacks paid by the manufacturer, Insys Therapeutics. Insys employed Tondre to work as a pharmaceutical sales representative for Chun\u2019s territory. Through Tondre, Insys paid more than $275,000 in kickbacks to Chun in the form of sham speaker fees and other benefits in return for Chun prescribing higher and larger quantities of Subsys. This case is being investigated by the FBI, HHS-OIG, and the Defense Criminal Investigation Service. It is being prosecuted by Assistant U.S. Attorney Kelley Howard-Allen. \u003Ci\u003EAdditional details can be found in \u003C\/i\u003E\u003Ca href=\u0022https:\/\/www.justice.gov\/usao-mdfl\/pr\/sarasota-pain-doctor-and-former-insys-sales-representative-charged-health-care-fraud\u0022\u003E\u003Ci\u003Epress release.\u003C\/i\u003E\u003C\/a\u003E\u003C\/p\u003E\n\n\u003Cp\u003EAn information or indictment is merely a formal charge that a defendant has committed one or more violations of federal criminal law, and every defendant is\u0026nbsp;presumed innocent unless, and until, proven guilty.\u003C\/p\u003E\n\n\u003Cp\u003E\u0026nbsp;\u003C\/p\u003E","changed":"\u003Ctime datetime=\u00222020-10-01T09:26:48-04:00\u0022\u003E1601558808\u003C\/time\u003E\n","component":[{"uuid":"e677f388-f122-47ab-babc-c87013ef6c38","name":"Office of the Inspector General"},{"uuid":"544d3323-77d6-4482-917e-ff6c9b4a2fae","name":"USAO - Florida, Middle"}],"created":"\u003Ctime datetime=\u00222020-09-30T17:25:30-04:00\u0022\u003E1601501130\u003C\/time\u003E\n","date":"1601467200","image":"","number":"","teaser":"\u003Cp\u003EWASHINGTON \u2013\u00a0Acting Assistant Attorney General Brian C. Rabbitt of the Justice Department\u2019s Criminal Division, Assistant Director Calvin Shivers of the FBI\u2019s Criminal Investigative Division, Deputy Inspector General Gary Cantrell of the Department of Health and Human Services Office of Inspector General (HHS-OIG) and Assistant Administrator Tim McDermott of the Drug Enforcement Administration (DEA) today announced a historic nationwide enforcement action involving 345 charged defendants across 51 federal districts, including more than 100 doctors, nurses, and other licensed medical professionals.\u00a0\u003C\/p\u003E\n","title":"National Health Care Fraud And Opioid Takedown Results In Largest Enforcement Action In Department Of Justice History","topic":[{"uuid":"77a2d846-a826-49db-a31a-c5db747e9ad3","name":"Financial Fraud"},{"uuid":"cce5d791-6b0b-462d-9a42-768179164d43","name":"Healthcare Fraud"}],"url":"https:\/\/www.justice.gov\/usao-mdfl\/pr\/national-health-care-fraud-and-opioid-takedown-results-largest-enforcement-action","uuid":"ab4b3b40-e2ea-4023-aaf6-532eb1b89767"},{"attachment":"","body":"\u003Cp\u003EThe Department of Justice announced today criminal charges against 138 defendants, including 42 doctors, nurses, and other licensed medical professionals, in 31 federal districts across the United States for their alleged participation in various health care fraud schemes that resulted in approximately $1.4 billion in alleged losses.\u003C\/p\u003E\n\n\u003Cp\u003EThe charges target approximately $1.1 billion in fraud committed using telemedicine (the use of telecommunications technology to provide health care services remotely), $29 million in COVID-19 health care fraud, $133 million connected to substance abuse treatment facilities, or \u201csober homes,\u201d and $160 million connected to other health care fraud and illegal opioid distribution schemes across the country.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThis nationwide enforcement action demonstrates that the Criminal Division is at the forefront of the fight against health care fraud and opioid abuse by prosecuting those who have exploited health care benefit programs and their patients for personal gain,\u201d said Assistant Attorney General Kenneth A. Polite Jr. of the Justice Department\u2019s Criminal Division. \u201cThe charges announced today send a clear deterrent message and should leave no doubt about the department\u2019s ongoing commitment to ensuring the safety of patients and the integrity of health care benefit programs, even amid a continued pandemic.\u201d\u003C\/p\u003E\n\n\u003Cp\u003EToday\u2019s enforcement actions were led and coordinated by the Health Care Fraud Unit of the Criminal Division\u2019s Fraud Section, in conjunction with its Health Care Fraud and Appalachian Regional Prescription Opioid (ARPO) Strike Force program and its core partners, the U.S. Attorneys\u2019 Offices, Department of Health and Human Services Office of Inspector General (HHS-OIG), FBI, and Drug Enforcement Administration (DEA), as part of the department\u2019s ongoing efforts to combat the devastating effects of health care fraud and the opioid epidemic. The cases are being prosecuted by Health Care Fraud and ARPO Strike Force teams from the Criminal Division\u2019s Fraud Section, in coordination with 31 U.S. Attorneys\u2019 Offices nationwide, and agents from HHS-OIG, FBI, DEA, and other federal and state law enforcement agencies.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cHealth care fraud targets the vulnerable in our communities, our health care system, and our basic expectation of competent, available care,\u201d said Assistant Director Calvin Shivers of the FBI\u2019s Criminal Investigative Division. \u201cDespite a continued pandemic, the FBI and our law enforcement partners remain dedicated to safeguarding American taxpayers and businesses from the steep cost of health care fraud.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cWe have seen all too often criminals who engage in health care fraud \u2014 stealing from taxpayers while jeopardizing the health of Medicare and Medicaid beneficiaries,\u201d said Deputy Inspector General for Investigations Gary L. Cantrell of HHS-OIG. \u201cToday\u2019s announcement should serve as another warning to individuals who may be considering engaging in such illicit activity: our agency and its law enforcement partners remain unrelenting in our commitment to rooting out fraud, holding bad actors accountable, and protecting the millions of beneficiaries who rely on federal health care programs.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cHolding to account those responsible for health care fraud and diversion of prescription drugs is a priority for DEA,\u201d said DEA Administrator Anne Milgram. \u201cThese fraudulent activities prey on our most vulnerable \u2013 those in pain, the substance-addicted, and even the homeless \u2013 those who are most susceptible to promises of relief, recovery, or a new start. Not only do these schemes profit from desperation, but they often leave their victims even deeper in addiction.\u0026nbsp;We are grateful to our partners who stand with us to keep our communities safer and healthier through our collective efforts to prevent the misuse and over-prescribing of controlled medications.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cEvery dollar saved is critical to the sustainability of our Medicare programs and meeting the needs of seniors and people with disabilities,\u201d said Centers for Medicare \u0026amp; Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure. \u201cCMS has taken actions against 28 providers on behalf of people with Medicare coverage and to protect the Medicare Trust Fund. Actions like this to combat fraud, waste and abuse in our federal programs would not be possible without the successful partnership of Centers for Medicare \u0026amp; Medicaid Services, the Department of Justice and the U.S. Department of Health and Human Services, Office of Inspector General.\u201d\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cstrong\u003ETelemedicine Fraud Cases\u003C\/strong\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe largest amount of alleged fraud loss charged in connection with the cases announced today \u2013 over $1.1 billion in allegedly false and fraudulent claims submitted by more than 43 criminal defendants in 11 judicial districts \u2013 relates to schemes involving telemedicine. According to court documents, certain defendant telemedicine executives allegedly paid doctors and nurse practitioners to order unnecessary durable medical equipment, genetic and other diagnostic testing, and pain medications, either without any patient interaction or with only a brief telephonic conversation with patients they had never met or seen. Durable medical equipment companies, genetic testing laboratories, and pharmacies then purchased those orders in exchange for illegal kickbacks and bribes and submitted over $1.1 billion in false and fraudulent claims to Medicare and other government insurers. In some instances, medical professionals billed Medicare for sham telehealth consultations that did not occur as represented. The proceeds of the scheme were spent on luxury items, including vehicles, yachts, and real estate.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EThe continued focus on prosecuting health care fraud schemes involving telemedicine reflects the success of the nationwide coordinating role of the Fraud Section\u2019s National Rapid Response Strike Force, the creation of which was announced at the \u003Ca href=\u0022https:\/\/www.justice.gov\/opa\/pr\/national-health-care-fraud-and-opioid-takedown-results-charges-against-345-defendants\u0022\u003E2020 National Health Care Fraud and Opioid Takedown\u003C\/a\u003E. The National Rapid Response Strike Force helped coordinate the prosecution of the telemedicine initiative, Sober Homes initiative, and COVID-19 cases that were announced today. The focus on telemedicine fraud also builds on the telemedicine component of last year\u2019s national takedown and the impact of the \u003Ca href=\u0022https:\/\/www.justice.gov\/opa\/pr\/federal-law-enforcement-action-involving-fraudulent-genetic-testing-results-charges-against\u0022\u003E2019 \u201cOperation Brace Yourself\u201d Telemedicine and Durable Medical Equipment Takedown\u003C\/a\u003E, which resulted in an estimated cost avoidance of more than $1.9 billion in the amount paid by Medicare for orthotic braces in the 20 months following that takedown.\u003C\/p\u003E\n\n\u003Cp\u003E\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cstrong\u003ECOVID-19 Fraud Cases\u003C\/strong\u003E\u003C\/p\u003E\n\n\u003Cp\u003ENine defendants in the cases announced today are alleged to have engaged in various health care fraud schemes designed to exploit the COVID-19 pandemic, which resulted in the submission of over $29 million in false billings. In one type of scheme, defendants are alleged to have exploited policies that were put in place by the CMS to enable increased access to care during the COVID-19 pandemic, such as expanded telehealth regulations and rules. Defendants allegedly misused patient information to submit claims to Medicare for unrelated, medically unnecessary, and expensive laboratory tests, including cancer genetic testing.\u003C\/p\u003E\n\n\u003Cp\u003EThe law enforcement action today also includes criminal charges against five defendants who allegedly engaged in the misuse of Provider Relief Fund monies. The Provider Relief Fund is part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, a federal law enacted March 2020 designed to provide needed medical care to Americans suffering from COVID-19. The defendants allegedly used the moneys for their own personal expenses, including for gambling at a Las Vegas casino and paying a luxury car dealership.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EThe COVID-19 cases announced today build upon the success of the \u003Ca href=\u0022https:\/\/www.justice.gov\/opa\/pr\/doj-announces-coordinated-law-enforcement-action-combat-health-care-fraud-related-covid-19\u0022\u003ECOVID-19 Health Care Fraud Takedown on May 26\u003C\/a\u003E, a coordinated law enforcement action against 14 defendants in seven judicial districts for over $128 million in false billings. The law enforcement action and the cases announced today were brought in coordination with the Health Care Fraud Unit\u2019s COVID-19 Interagency Working Group, which is chaired by the National Rapid Response Strike Force and organizes efforts to address illegal activity involving health care programs during the pandemic.\u003C\/p\u003E\n\n\u003Cp\u003E\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cstrong\u003ESober Homes Cases\u003C\/strong\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe sober homes cases are announced on the one-year anniversary of the first ever national sober homes initiative in 2020, which included charges against more than a dozen criminal defendants in connection with more than $845 million of allegedly false and fraudulent claims for tests and treatments for vulnerable patients seeking treatment for drug and\/or alcohol addiction. The over $133 million in false and fraudulent claims that are additionally alleged in cases announced today reflect the continued effort by the National Rapid Response Strike Force and the Health Care Fraud Unit\u2019s Los Angeles Strike Force, with the participation of the U.S. Attorneys\u2019 Offices for the Central District of California and the Southern District of Florida, to prosecute those who participated in illegal kickback and bribery schemes involving the referral of patients to substance abuse treatment facilities; those patients could be subjected to medically unnecessary drug testing \u2013 often billing thousands of dollars for a single test \u2013 and therapy sessions that frequently were not provided, and which resulted in millions of dollars of false and fraudulent claims being submitted to private insurers.\u003C\/p\u003E\n\n\u003Cp\u003E\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cstrong\u003ECases Involving the Illegal Prescription and\/or Distribution of Opioids and Cases Involving Traditional Health Care Fraud Schemes \u003C\/strong\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe cases announced today involving the illegal prescription and\/or distribution of opioids involve 19 defendants, including several charges against medical professionals and others who prescribed over 12 million doses of opioids and other prescription narcotics, while submitting over $14 million in false billings. The cases that fall into more traditional categories of health care fraud include charges against over 60 defendants who allegedly participated in schemes to submit more than $145 million in false and fraudulent claims to Medicare, Medicaid, TRICARE, and private insurance companies for treatments that were medically unnecessary and often never provided.\u003C\/p\u003E\n\n\u003Cp\u003EPrior to the charges announced as part of today\u2019s nationwide enforcement action and since its inception in March 2007, the Health Care Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,600 defendants who have collectively billed the Medicare program for approximately $23 billion. In addition to the criminal actions announced today, CMS, working in conjunction with HHS-OIG, announced 28 administrative actions to decrease the presence of fraudulent providers.\u003C\/p\u003E\n\n\u003Cp\u003E\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EA complaint, information or indictment is merely an allegation, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.\u003C\/p\u003E\n\n\u003Cp\u003ETo view Assistant Attorney General Polite\u2019s remarks, see\u0026nbsp;\u003Ca href=\u0022https:\/\/www.justice.gov\/opa\/video\/assistant-attorney-general-kenneth-polite-jr-delivers-remarks-health-care-enforcement\u0022\u003Ehttps:\/\/www.justice.gov\/opa\/video\/assistant-attorney-general-kenneth-polite-jr-delivers-remarks-health-care-enforcement\u003C\/a\u003E.\u003C\/p\u003E","changed":"\u003Ctime datetime=\u00222025-02-06T08:06:05-05:00\u0022\u003E1738847165\u003C\/time\u003E\n","component":[{"uuid":"46370d9f-afee-4408-a29b-48812154bc0c","name":"Criminal Division"},{"uuid":"a618801c-2b1e-4ce0-b47e-4db0bce55ac2","name":"Criminal - Criminal White Collar and Corporate Enforcement"}],"created":"\u003Ctime datetime=\u00222021-09-17T12:10:50-04:00\u0022\u003E1631895050\u003C\/time\u003E\n","date":"1631880000","image":"","number":"21-891","teaser":"\u003Cp\u003EThe Department of Justice announced today criminal charges against 138 defendants, including 42 doctors, nurses, and other licensed medical professionals, in 31 federal districts across the United States for their alleged participation in various health care fraud schemes that resulted in approximately $1.4 billion in alleged losses.\u003C\/p\u003E\n","title":"National Health Care Fraud Enforcement Action Results in Charges Involving over $1.4 Billion in Alleged Losses","topic":[{"uuid":"6827a162-b783-4ffa-a6c2-596fc9f07e39","name":"COVID-Related Fraud"},{"uuid":"b7ce2474-26e0-427a-94c4-95dee8df26cb","name":"Disaster Fraud"},{"uuid":"51b9125c-0741-4d24-a339-41f553c87538","name":"Opioids"},{"uuid":"cce5d791-6b0b-462d-9a42-768179164d43","name":"Healthcare Fraud"}],"url":"https:\/\/www.justice.gov\/archives\/opa\/pr\/national-health-care-fraud-enforcement-action-results-charges-involving-over-14-billion","uuid":"1ab6b04d-1015-4810-b151-ec885f625407"},{"attachment":"","body":"\u003Cp\u003E\u003Cb\u003EWASHINGTON:\u003C\/b\u003E A strategically coordinated, six-week nationwide federal law enforcement action has resulted in criminal charges against 138 defendants, including 42 doctors, nurses, and other licensed medical professionals, in 31 federal districts across the United States for their alleged participation in various healthcare fraud schemes for more than $1.4 billion in alleged losses.\u003C\/p\u003E\n\n\u003Cp\u003EThe enforcement action includes criminal charges against six defendants here in the Southern District of Georgia. The charges announced involve some defendants accused of committing a kickback conspiracy involving cancer genomic testing claims, and other defendants accused of illegal distribution of opioids. The Southern District of Georgia\u2019s announced charges account for more than $50 million in collective billings to federal health benefit programs.\u003C\/p\u003E\n\n\u003Cp\u003ENationwide, the charges target approximately $1.1 billion in fraud committed using telemedicine, more than $29 million in COVID-19 health care fraud, more than $133 million connected to substance abuse treatment facilities, or \u201csober homes,\u201d and more than $160 million connected to other health care fraud and illegal opioid distribution schemes across the country.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThe vigilance of our law enforcement partners plays a vital role in identifying illegal healthcare activities throughout the nation and the Southern District of Georgia,\u201d said David H. Estes, Acting U.S. Attorney for the Southern District of Georgia. \u201cWe will continue to hold accountable those who would seek to gain illicit profit by criminally exploiting our nation\u2019s healthcare safety net.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThis nationwide enforcement action demonstrates that the Criminal Division is at the forefront of the fight against health care fraud and opioid abuse by prosecuting those who have exploited health care benefit programs and their patients for personal gain,\u201d said Assistant Attorney General Kenneth A. Polite Jr. of the Justice Department\u2019s Criminal Division. \u201cThe charges announced today send a clear deterrent message and should leave no doubt about the department\u2019s ongoing commitment to ensuring the safety of patients and the integrity of health care benefit programs, even amid a continued pandemic.\u201d\u003C\/p\u003E\n\n\u003Cp\u003EToday\u2019s enforcement actions were led and coordinated by the Health Care Fraud Unit of the Criminal Division\u2019s Fraud Section, in conjunction with its Health Care Fraud and Appalachian Regional Prescription Opioid (ARPO) Strike Force program, and its core partners, the U.S. Attorneys\u2019 Offices, the Department of Health and Human Services Office of Inspector General (HHS-OIG), FBI, and the Drug Enforcement Administration (DEA), as part of the department\u2019s ongoing efforts to combat the devastating effects of health care fraud and the opioid epidemic. The Southern District of Georgia worked with the Justice Department\u2019s Criminal Division and agents from HHS-OIG, FBI, and DEA in the investigation and prosecution of these cases.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003ETelemedicine Fraud Cases\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe largest amount of alleged fraud loss charged in connection with the cases announced today \u2013 more than $1.1 billion in allegedly false and fraudulent claims submitted by 43 criminal defendants in 11 judicial districts nationwide \u2013 relates to schemes involving telemedicine: the use of telecommunications technology to provide health care services remotely. In the Southern District of Georgia, two marketers were charged by way of Information relating to their role in a conspiracy that bought and sold cancer genomic (\u201cCGx\u201d) testing for Medicare beneficiaries. Court documents allege that the CGx tests bought in that conspiracy were ultimately billed to Medicare by a series of laboratories for more than $45 million.\u003C\/p\u003E\n\n\u003Cp\u003EThe continued focus on prosecuting health care fraud schemes involving telemedicine reflects the success of the nationwide coordinating role of the Fraud Section\u2019s National Rapid Response Strike Force.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cHealthcare crimes hurt every taxpayer and put profits over the care of our nation\u2019s most vulnerable citizens,\u201d said Chris Hacker, Special Agent in Charge of FBI Atlanta. \u201cIt puts a tremendous strain on our federally-subsidized health care programs. The FBI and our federal partners will hold accountable anyone who usurps healthcare assistance for their personal greed.\u201d\u003C\/p\u003E\n\n\u003Cp\u003EThe focus on telemedicine fraud also builds on the telemedicine component of last year\u2019s national takedown and the impact of the 2019 \u201cOperation Brace Yourself\u201d Telemedicine and Durable Medical Equipment Takedown, which resulted in an estimated cost avoidance of more than $1.9 billion in the amount paid by Medicare for orthotic braces in the 20 months following that takedown. The Southern District of Georgia has played a major role in these nationwide schemes, having charged more than 30 defendants responsible for a collective $1.6 billion in billings across Operation Brace Yourself, Operation Double Helix, and Operation Rubber Stamp. The Southern District of Georgia kickback charges announced today are being prosecuted by Assistant U.S. Attorney Jonathan A. Porter.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003ECases Involving the Illegal Prescription and\/or Distribution of Opioids and Cases Involving Traditional Health Care Fraud Schemes \u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe cases announced today involving the illegal prescription and\/or distribution of opioids include 19 defendants, including several charges against medical professionals and others who prescribed more than 12 million doses of opioids and other prescription narcotics while submitting more than $14 million in false billings. The cases that fall into more traditional categories of healthcare fraud include charges against more than 60 defendants who allegedly participated in schemes to submit more than $145 million in false and fraudulent claims to Medicare, Medicaid, TRICARE, and private insurance companies for treatments that were medically unnecessary and often never provided.\u003C\/p\u003E\n\n\u003Cp\u003EIn the Southern District of Georgia, three South Georgia medical professionals were indicted for illegal distribution of opioids and conspiracy to commit health care fraud. The indictment alleges that the charged physician, nurse practitioner, and physician assistant operated a nominal pain clinic that distributed opioids with no legitimate medical purpose. These charges are being prosecuted by Assistant U.S. Attorneys Matthew A. Josephson and Bradford C. Patrick.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThe public relies on medical professionals to be part of the solution to our nation\u2019s prescription drug abuse epidemic \u2013 not to worsen the problem by distributing controlled substances without a legitimate medical purpose,\u0022 said Special Agent in Charge Derrick L. Jackson of HHS-OIG. \u201cWorking closely with our law enforcement partners, we will continue to investigate unscrupulous providers who prey on vulnerable members of the public.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cMedical practitioners who unlawfully dispense dangerous, addictive and potentially deadly substances do so under the guise of a stethoscope and white coat to hide behind a veil of legitimacy. They commit fraudulent acts and prey on patients who are addicted to prescription opioids and are unfit to administer care to anyone,\u201d said Robert J. Murphy, Special Agent in Charge of the DEA Atlanta Field Division. \u201cDEA and its law enforcement partners stand united and are committed to bringing those to justice who engage in these unlawful acts.\u201d\u003C\/p\u003E\n\n\u003Cp\u003EPrior to the charges announced as part of today\u2019s nationwide enforcement action and since its inception in March 2007, the Health Care Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,600 defendants who have collectively billed the Medicare program for approximately $23 billion. In addition to the criminal actions announced today, CMS, working in conjunction with HHS-OIG, announced 28 administrative actions to decrease the presence of fraudulent providers.\u003C\/p\u003E\n\n\u003Cp\u003EThe National Rapid Response Strike Force also announced prosecutions across the country today regarding $128 million in COVID-19 fraud, cases and nearly $1 billion in fraud cases involving sober homes.\u003C\/p\u003E\n\n\u003Cp\u003EA complaint, information or indictment is merely an allegation, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.\u003C\/p\u003E\n\n\u003Cp\u003ETo view Assistant Attorney General Polite\u2019s remarks,\u0026nbsp;go to: \u003Ca href=\u0022https:\/\/www.justice.gov\/opa\/video\/assistant-attorney-general-kenneth-polite-jr-delivers-remarks-health-care-enforcement\u0022\u003Ehttps:\/\/www.justice.gov\/opa\/video\/assistant-attorney-general-kenneth-polite-jr-delivers-remarks-health-care-enforcement\u003C\/a\u003E.\u003C\/p\u003E","changed":"\u003Ctime datetime=\u00222021-09-17T13:38:51-04:00\u0022\u003E1631900331\u003C\/time\u003E\n","component":[{"uuid":"4f03e6af-f2cb-40c6-89c8-6871fdd8aa47","name":"Drug Enforcement Administration (DEA)"},{"uuid":"dca09ceb-4978-4466-9c30-ce9f5ada2f0a","name":"Federal Bureau of Investigation (FBI)"},{"uuid":"e14d3a2a-8182-4984-aed0-95e811946fc8","name":"USAO - Georgia, Southern"}],"created":"\u003Ctime datetime=\u00222021-09-17T13:38:33-04:00\u0022\u003E1631900313\u003C\/time\u003E\n","date":"1631880000","image":"","number":"146-21","teaser":"\u003Cp\u003EA strategically coordinated, six-week nationwide federal law enforcement action has resulted in criminal charges against 138 defendants, including 42 doctors, nurses, and other licensed medical professionals, in 31 federal districts across the United States for their alleged participation in various healthcare fraud schemes for more than $1.4 billion in alleged losses.\u003C\/p\u003E\n","title":"National healthcare fraud enforcement action results in charges involving more than $1.4 billion in alleged losses","topic":[{"uuid":"cce5d791-6b0b-462d-9a42-768179164d43","name":"Healthcare Fraud"}],"url":"https:\/\/www.justice.gov\/usao-sdga\/pr\/national-healthcare-fraud-enforcement-action-results-charges-involving-more-14-billio-0","uuid":"6ccb0be8-fa0a-4d81-b218-5a1ecd677d47"},{"attachment":"","body":"\u003Cp\u003EMiami, Florida \u2013 Over 50 defendants were charged in the Southern District of Florida in the last six weeks, as part of a nationwide federal law enforcement action to combat health care fraud.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EThe federal charges filed in South Florida cover a wide range of schemes, from novel crimes like theft of Covid-19 personal protection equipment and fraud connected to substance abuse treatment facilities (sober homes), to more familiar violations like health care fraud involving durable medical equipment suppliers, home health, pharmacies, payment of kickbacks, money laundering, and more. \u0026nbsp;It is alleged that $308 million in fraudulent claims was billed by the defendants charged in the Southern District of Florida during the six-week enforcement period.\u0026nbsp; Over $106 million of that billed amount was paid. \u0026nbsp;\u0026nbsp;\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003ENationwide, 138 defendants, including 42 doctors, nurses, and other licensed medical professionals, in 31 federal districts across the United States, were charged during the enforcement period for their alleged participation in various healthcare fraud schemes that resulted in approximately $1.4 billion in alleged losses. Nationally, the charges target approximately $1.1 billion in fraud committed using telemedicine (the use of telecommunications technology to provide health care services remotely), $29 million in COVID-19 health care fraud, $133 million connected to substance abuse treatment facilities, or \u201csober homes,\u201d and $160 million connected to other health care fraud and illegal opioid distribution schemes across the country.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThe results of the coordinated law enforcement effort that we announce today exemplify my Office and its law enforcement partners\u2019 enduring commitment to combatting all forms of health care fraud-related schemes.\u201d said Juan Antonio Gonzalez, Acting U.S. Attorney for the Southern District of Florida. \u201cWe will not relent in holding accountable those in South Florida who exploit health care programs and patient trust for personal gain, particularly during the COVID-19 global pandemic.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThis nationwide enforcement action demonstrates that the Criminal Division is at the forefront of the fight against health care fraud and opioid abuse by prosecuting those who have exploited health care benefit programs and their patients for personal gain,\u201d said Assistant Attorney General Kenneth A. Polite Jr. of the Justice Department\u2019s Criminal Division. \u201cThe charges announced today send a clear deterrent message and should leave no doubt about the department\u2019s ongoing commitment to ensuring the safety of patients and the integrity of health care benefit programs, even amid a continued pandemic.\u201d\u003C\/p\u003E\n\n\u003Cp\u003EToday\u2019s enforcement actions were led and coordinated by the Health Care Fraud Unit of the Criminal Division\u2019s Fraud Section, in conjunction with its Health Care Fraud and Appalachian Regional Prescription Opioid (ARPO) Strike Force program, and its core partners, the U.S. Attorneys\u2019 Offices, the Department of Health and Human Services Office of Inspector General (HHS-OIG), FBI, and the Drug Enforcement Administration (DEA), as part of the department\u2019s ongoing efforts to combat the devastating effects of health care fraud and the opioid epidemic.\u003C\/p\u003E\n\n\u003Cp\u003EThe Southern District of Florida, in particular, worked with the Department\u2019s Criminal Division and the following law enforcement organizations to investigate and prosecute the cases filed during the enforcement period: FBI Miami; U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), Miami Region; Social Security Administration, Office of Inspector General (SSA-OIG), Atlanta Field Division; Homeland Security Investigations (HSI), Miami; United States Postal Inspection Service (USPIS), Miami Region; Florida\u2019s Office of the Attorney General, Medicaid Fraud Control Unit (MFCU); Florida State Attorney\u2019s Office; City of Miami Beach Police Department; Palm Beach County Sober Homes Task Force; Amtrack Office of the Inspector General; and the Department of Insurance Fraud.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cSouth Florida is ground zero for health care fraud.\u0026nbsp; As such, the FBI and its partners devote vast resources to investigate, catch and prosecute those committing this fraud,\u201d said George L. Piro, Special Agent in Charge, FBI Miami. \u0026nbsp;The victims are U.S. taxpayers, you and me.\u0026nbsp; Our message to those who commit health care fraud and steal from U.S. taxpayers is clear: you will be caught, and you will be punished.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cHealthcare fraud is hardly a victimless crime.\u0026nbsp;The well-being and trust of patients and taxpayers are at risk when corrupt providers engage in schemes that drain taxpayer-funded health care programs and undermine impartial medical judgement,\u201d said Special Agent in Charge\u0026nbsp;Omar P\u00e9rez Aybar of HHS-OIG Miami. \u201cThese cases demonstrate our resolve to investigate bad actors and protect the patients served by vital federal health and human services programs.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u003Ci\u003E\u201c\u003C\/i\u003EThose who misuse the Social Security numbers of other individuals for personal gain are warned -- we will hold you accountable.\u201d said Rodregas W. Owens, Special Agent-in-Charge, SSA-OIG, Atlanta Field Division. \u201cWe will continue to work aggressively to identify such fraud in an effort to protect taxpayers against fraud, waste, and abuse.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cWe as a law enforcement community will not allow individuals to defraud government health-care programs for their own personal gain,\u201d said Anthony Salisbury, Special Agent in Charge, HSI Miami. \u201cHSI and its partners will continue to pursue individuals and companies who are taking advantage of innocent patients seeking medical care.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cMy Medicaid Fraud Control Unit works tirelessly to stop the exploitation of the taxpayer-funded Medicaid program and protect the vulnerable Floridians who rely on its services. I\u2019m proud of our partnership with federal authorities to hold these criminals abusing the system accountable,\u201d said Florida Attorney General Ashley Moody.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003ECOVID-19 Fraud Cases\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003EAcross the nation, nine defendants are charged with engaging in various health care fraud schemes designed to exploit the COVID-19 pandemic, which resulted in the submission of over $29 million in false billings.\u003C\/p\u003E\n\n\u003Cp\u003EIn the Southern District of Florida, for example, a defendant is charged with stealing personal protective equipment from a hospital and reselling it at inflated prices: \u0026nbsp;\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Cb\u003E\u003Ci\u003EU.S. v. Rickey Delancey, Jr.\u003C\/i\u003E\u003C\/b\u003E\u003Ci\u003E,\u003C\/i\u003E Case No.\u003Cb\u003E \u003C\/b\u003E21-20471-Cr-Moore, a 30-year-old Miami resident is charged by indictment with conspiracy to steal medical products, theft of medical products, and transportation of stolen goods. According to the indictment, Delancey worked in the supplies department of Mount Sinai Hospital. From about April to November 2020, Delancey stole N95 masks and other medical supplies from his workplace and sold them to various purchasers.\u0026nbsp; Among other items, he sold $55,000 worth of stolen masks to a purchaser in California, says the indictment. As a result of the thefts, during the height of the COVID-19 pandemic, Mount Sinai did not have the supplies needed for nurses, doctors, staff, and patients, and at one point was down to only a three-day supply of N95 masks.\u003C\/p\u003E\n\n\u003Cp\u003EFBI Miami and USPIS Miami investigated this case, along with City of Miami Beach Police Department.\u0026nbsp; Southern District of Florida Assistant U.S. Attorney Lindsey Lazopoulos Friedman is prosecuting it.\u003C\/p\u003E\n\n\u003Cp\u003EThe law enforcement action today also includes criminal charges against five defendants across the country who allegedly engaged in the misuse of Provider Relief Fund monies. The Provider Relief Fund is part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, a federal law enacted March 2020 designed to provide needed medical care to Americans suffering from COVID-19.\u003C\/p\u003E\n\n\u003Cp\u003EThe COVID-19 cases announced today build upon the success of the \u003Ca href=\u0022https:\/\/www.justice.gov\/opa\/pr\/doj-announces-coordinated-law-enforcement-action-combat-health-care-fraud-related-covid-19\u0022\u003ECOVID-19 Health Care Fraud Takedown on May 26\u003C\/a\u003E, a coordinated law enforcement action against 14 defendants in seven judicial districts for over $128 million in false billings. The law enforcement action and the cases announced today were brought in coordination with the Health Care Fraud Unit\u2019s COVID-19 Interagency Working Group, which is chaired by the National Rapid Response Strike Force and organizes efforts to address illegal activity involving health care programs during the pandemic.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003ESober Homes Cases\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003EToday\u2019s announcement of sober homes cases charged across the nation coincides with the one-year anniversary of the first national sober homes initiative in 2020, which included charges against more than a dozen criminal defendants in connection with more than $845 million of allegedly false and fraudulent claims for tests and treatments for vulnerable patients seeking treatment for drug and\/or alcohol addiction. The over $133 million in false and fraudulent claims that are additionally alleged in cases announced today reflect the continued effort by the National Rapid Response Strike Force and the Health Care Fraud Unit\u2019s Los Angeles Strike Force, with the participation of the U.S. Attorney\u2019s Offices for the Central District of California and the Southern District of Florida, to prosecute those who participated in illegal kickback and bribery schemes involving the referral of patients to substance abuse treatment facilities; those patients could be subjected to medically unnecessary drug testing \u2013 often billing thousands of dollars for a single test \u2013 and therapy sessions that frequently were not provided, and which resulted in millions of dollars of false and fraudulent claims being submitted to private insurers.\u003C\/p\u003E\n\n\u003Cp\u003EIn the Southern District of Florida, two defendants are charged with sober homes fraud:\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Cb\u003E\u003Ci\u003EUnited States v. Mimi Bieda and Levi Bieda a\/k\/a Larry\u003C\/i\u003E, \u003C\/b\u003ECase No. 21-80112-CR-Rosenberg, Mimi Bieda, 62, and Levi Bieda, 36, of West Palm Beach, Florida, are charged by information with conspiracy to commit $128 million of health care fraud.\u0026nbsp; According to the information, the Biedas owned and operated Academy Health Solutions, LLC (\u201cAcademy\u201d), a substance abuse treatment center in Palm Beach County, Florida, as well as a sober home and detox facilities.\u0026nbsp; They also had ownership interest in several drug testing laboratories.\u0026nbsp; It is alleged that the Biedas hired a medical director for Academy, Dr. Michael Ligotti, who signed standing orders for medically unnecessary and expensive drug testing in exchange for patient referrals. Dr. Ligotti then billed the patients\u2019 insurance plans for duplicative, excessive, non-rendered, and\/or medically unnecessary treatment and testing.\u0026nbsp; The Biedas used the standing orders signed by Dr. Ligotti, and by a subsequent medical director at Academy, to authorize medically unnecessary drug testing at laboratories in which they had an ownership interest, allowing them to receive percentages of all claim reimbursements for those tests, says the information. It is alleged that the Biedas also paid kickbacks and bribes, in the form of free or reduced rent, access to controlled substances provided by Academy\u2019s medical directors, and other benefits, to individuals who agreed to live at their sober home, attend treatment at Academy, and submit to drug testing, so that the Biedas could bill these services to the residents\u2019 insurance plans.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EFBI Miami investigated this case, along with Palm Beach County Sober Homes Task Force, Florida State Attorney\u2019s Office, Amtrack Office of the Inspector General, and Department of Insurance Fraud. \u0026nbsp;Southern District of Florida Assistant United States Attorneys Alexandra Chase and Danielle Croke, as well as National Rapid Response Strike Force Senior Litigation Counsel James V. Hayes and Trial Attorney Ligia Markman are prosecuting it. \u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003ECases Involving Traditional Healthcare Fraud Schemes and the Illegal Prescription and\/or Distribution of Opioids \u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe cases announced today that fall into more traditional categories of health care fraud include charges filed across the nation against over 60 defendants who allegedly participated in schemes to submit more than $145 million in false and fraudulent claims to Medicare, Medicaid, TRICARE, and private insurance companies for treatments that were medically unnecessary and often never provided. Cases filed across the nation involving the illegal prescription and\/or distribution of opioids involve 19 defendants, including several charges against medical professionals and others who prescribed over 12 million doses of opioids and other prescription narcotics, while submitting over $14 million in false billings.\u003C\/p\u003E\n\n\u003Cp\u003EIn the Southern District of Florida, defendants are charged in cases involving a wide range of traditional health care fraud schemes.\u0026nbsp; Some of the cases charged in the Southern District of Florida during the six-week enforcement period include the following:\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Cb\u003E\u003Ci\u003EUnited States v. Edward Pizzi\u003C\/i\u003E, \u003C\/b\u003ECase No. 21-20467-CR-Altman, a 40-year-old from Miami, Florida is charged by information with conspiracy to pay health care kickbacks. According to the information, Pizzi owned and operated Miami-based Rios Medical Center and Union Medical Clinic. Pizzi directed his employees to pay kickbacks to recruit Medicare beneficiaries and Medicaid recipients to the clinics.\u0026nbsp; The clinics used the identification numbers of these beneficiaries and recipients to submit claims to Medicare Part C and Medicaid for, among other things, purported mental health therapy services.\u0026nbsp; Most of the recruited beneficiaries neither needed nor qualified for such services. \u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EFBI Miami, HHS-OIG Miami, and MFCU investigated this case. Southern District of Florida Assistant U.S. Attorney Michael Homer is prosecuting it.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Cb\u003E\u003Ci\u003EUnited States v. Mayara Gonzalez Chaviano, \u003C\/i\u003E\u003C\/b\u003ECase No. 21-20468-CR-King, a 28-year-old Miami, Florida resident is charged by information with conspiracy to pay health care kickbacks.\u0026nbsp; According to the information, Chaviano was the office manager of Rios Medical Center and Union Medical Clinic, in Miami, Florida.\u0026nbsp; Chaviano managed the clinics\u2019 scheme to pay kickbacks to recruit Medicare beneficiaries and Medicaid recipients to the clinics. The clinics used the identification numbers of these beneficiaries and recipients to submit claims to Medicare Part C and Medicaid for, among other things, purported mental health therapy services.\u0026nbsp; Most of the recruited beneficiaries neither needed nor qualified for such services.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EFBI Miami, HHS-OIG Miami, and MFCU investigated this case. Southern District of Florida Assistant U.S. Attorney Michael Homer is prosecuting it.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Cb\u003E\u003Ci\u003EUnited States v. Liliana Liseth Duarte, \u003C\/i\u003E\u003C\/b\u003ECase No. 21-20469-CR-Bloom, a 47-year-old resident of Miami, Florida, is charged by information with conspiracy to pay health care kickbacks.\u0026nbsp; According to the information, Duarte was an employee of Rios Medical Center and Union Medical Clinic, in Miami, Florida. Duarte paid kickbacks to individuals to recruit Medicare beneficiaries and Medicaid recipients to the clinics. The clinics used the identification numbers of these beneficiaries and recipients to submit claims to Medicare Part C and Medicaid for, among other things, purported mental health therapy services.\u0026nbsp; Most of the recruited beneficiaries neither needed nor qualified for such services.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EFBI Miami, HHS-OIG Miami, MFCU investigated this case. Southern District of Florida Assistant U.S. Attorney Michael Homer is prosecuting it.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Cb\u003E\u003Ci\u003EUnited States v. Jason Kashou, \u003C\/i\u003E\u003C\/b\u003ECase No. 21-60245-CR-Dimitrouleas, the 35-year-old owner of 1\u003Csup\u003Est\u003C\/sup\u003E Choice is charged by information with conspiracy to solicit and receive illegal kickbacks from pharmacies.\u003Cb\u003E \u003C\/b\u003EKashou bought Medicare and Medicaid beneficiary information from a call center in India. Kashou then agreed to provide the beneficiary information to pharmacies so that the pharmacies could fill prescriptions for expensive diabetic supplies and topical pain creams. In exchange, the pharmacies agreed to pay Kashou a percentage of the profits from the amount Medicare and Medicaid paid on a per patient basis.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EOn September 14, Kashou pled guilty to the charge.\u0026nbsp; His sentencing hearing is set for\u003Cb\u003E \u003C\/b\u003ENovember 23, at 1:15 p.m., before U.S. District Judge William P. Dimitrouleas.\u003Cb\u003E \u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003EHSI Miami, HHS-OIG Miami and MFCU investigated this case. Southern District of Florida Assistant U.S. Attorneys Stephanie Hauser and Michael Gilfarb are prosecuting it.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Cb\u003E\u003Ci\u003EUnited States v. Greisy Rosario Varona Docasal\u003C\/i\u003E, \u003C\/b\u003ECase No. 21-20439-CR-Cooke, a 52-year-old Miami, Florida resident is charged by indictment with conspiracy to receive health care kickbacks, and substantive counts of receiving kickbacks in connection with a federal health care program. According t0 the indictment, Varona Docasal, as office manager of a doctor\u2019s office, was involved in a scheme to illegally recruit Medicare beneficiaries and refer them to home health agencies in exchange for receiving illegal kickbacks from the owners and operators of the home health agencies who in turn billed Medicare for home health services for the recruited Medicare beneficiaries.\u003C\/p\u003E\n\n\u003Cp\u003EHHS-OIG Miami investigated this case. Southern District of Florida Assistant U.S. Attorney Aimee C. Jimenez is prosecuting it.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Cb\u003E\u003Ci\u003EUnited States v. Mayra De La Paz, \u003C\/i\u003E\u003C\/b\u003ECase No.\u003Cb\u003E \u003C\/b\u003E21-20474-CR-Bloom, a 69-year-old resident of \u003Cstrong\u003EHialeah, Florida is charged by information with conspiracy to solicit and receive kickbacks in connection with a federal health care program.\u0026nbsp; According to the information, De La Paz participated in a conspiracy to solicit and receive kickback payments for the referral of Medicare beneficiaries to a home health agency.\u003C\/strong\u003E\u003Cstrong\u003E \u003C\/strong\u003E\u003C\/p\u003E\n\n\u003Cp\u003EHHS-OIG Miami and FBI Miami investigated this case. Southern District of Florida Assistant U.S. Attorney Timothy J. Abraham is prosecuting it.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Cb\u003E\u003Ci\u003EU.S. v. Michael Marcelus Mogollon, \u003C\/i\u003E\u003C\/b\u003ECase No. 21-20432-CR-Moore, a 33-year-old from Miami, Florida is charged by information with conspiracy to commit health care and wire fraud. According to the information, Mogollon paid kickbacks to beneficiaries with Blue Cross Blue Shield health insurance in exchange for the patients allowing Miami clinics Quality Professional, Zion Medical, and Renewal to bill the insurance plans for medical benefits, items, and services, that were not medically necessary, not eligible for reimbursement, and not received by the beneficiaries. As a result of Mogollon\u2019s participation in the conspiracy, the clinics billed Blue Cross Blue Shield approximately $678,800, and Blue Cross Blue Shield paid approximately $220,000 based on the false claims, says the information.\u003C\/p\u003E\n\n\u003Cp\u003EFBI Miami investigated this case. Southern District of Florida Assistant U.S. Attorney Lindsey Lazopoulos Friedman is prosecuting it. \u0026nbsp;\u0026nbsp;\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Cb\u003E\u003Ci\u003EU.S. v. Jorge Luis Taboada, \u003C\/i\u003E\u003C\/b\u003ECase No. 21-20443-CR-Williams, a 52-year-old resident of Miami, Florida is charged by information with conspiracy to commit health care and wire fraud. According to the information, Taboada paid kickbacks to beneficiaries with Blue Cross Blue Shield and Aetna health insurance in exchange for the patients allowing United Medical of South Florida, d\/b\/a Sleep Study of South Florida, Inc. to bill the insurance plans for medical benefits, items, and services, that were not medically necessary, not eligible for reimbursement, and not received by the beneficiaries. As a result of Taboada\u2019s participation in the conspiracy, the clinics billed Blue Cross Blue Shield and Aetna between $1,500,000 and $3,500,000, says the information.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EFBI Miami investigated this case.\u0026nbsp; Southern District of Florida Assistant U.S. Attorney Lindsey Lazopoulos Friedman is prosecuting it. \u0026nbsp;\u0026nbsp;\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Cb\u003E\u003Ci\u003EUnited States of America vs. Patricia M. Cleary, a\/k\/a Patricia M. Cleary Syling, a\/k\/a Patricia M. Syling, a\/k\/a Patricia A. Cleary, \u003C\/i\u003E\u003C\/b\u003ECase No. 21-60262-CR-Singhal, a 51-year-old from Odessa, Florida is charged by indictment with one count of falsely representing a social security number and one count of aggravated identity theft.\u003C\/p\u003E\n\n\u003Cp\u003EAccording to the indictment, Cleary knowingly gave a false social security number to a Medicaid Managed Care Organization while applying for a job with the company. The social security number did not belong to Cleary. Instead, it belonged to a victim living in a different state. Cleary did this to hide her real identity from the company, says the indictment.\u003C\/p\u003E\n\n\u003Cp\u003EHHS-OIG Miami, State of Florida Medicaid Fraud Control Unit, SSA-OIG Miami, and FBI Miami investigated this case. Southern District of Florida Special Assistant U.S. Attorney Marc Canzio is prosecuting it.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Cb\u003E\u003Ci\u003EUnited States v. Julio Cesar Betancourt, \u003C\/i\u003E\u003C\/b\u003ECase No. 21-20425-CR-Moore, a 31-year-old resident of Hialeah Gardens, Florida is charged by information with conspiracy to commit money laundering.\u0026nbsp; According to the information, Betancourt, as owner of owner of JD Solution USA, Inc., conspired to launder $363,139 in health care fraud proceeds between July 2019 and October 2019.\u0026nbsp; These proceeds were related to a durable medical equipment company located in Miami that was committing health care fraud, says the information.\u003C\/p\u003E\n\n\u003Cp\u003EHHS-OIG Miami and FBI Miami investigated this case. Southern District of Florida Assistant U.S. Attorney Timothy J. Abraham is prosecuting it.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Cb\u003E\u003Ci\u003EUnited States v. Jorge Luis Lopez Pena, \u003C\/i\u003E\u003C\/b\u003ECase No. 21-CR-20466-Gayles, a 36-year-old from Miami, Florida is charged by information with conspiracy to commit money laundering.\u0026nbsp; According to the information, Lopez Pena, as owner of Lopez Distributors, Inc., conspired to launder $185,671 in health care fraud proceeds between August 2019 and December 2019. These health care fraud proceeds were related to a durable medical equipment company located in Miami that was committing health care fraud, says the information.\u003C\/p\u003E\n\n\u003Cp\u003EHHS-OIG Miami and FBI Miami investigated this case. Southern District of Florida Assistant U.S. Attorney Timothy J. Abraham is prosecuting it.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Cb\u003E\u003Ci\u003EU.S. v. Angel Pimentel, \u003C\/i\u003E\u003C\/b\u003ECase No. 21-20420-CR-King, a 72-year-old from Miami, Florida, is charged by indictment with conspiracy to commit health care fraud and substantive counts of health care fraud.\u0026nbsp; According to the indictment, Pimentel owned Maggie Pharmacy Discount, Inc. From about March 2015 to August 2019, Pimentel submitted $988,983 in claims to Medicare, which falsely and fraudulently represented that various health care benefits, primarily prescription drugs, were medically necessary, prescribed by a doctor, and had been provided by Maggie Pharmacy Discount, Inc. to Medicare beneficiaries.\u0026nbsp; As a result of the false claims, Medicare prescription drug plan sponsors, through their pharmacy benefit managers, made payments funded by the Medicare Part D Program to the corporate bank accounts of Maggie Pharmacy Discount, Inc. of at least $988,983, says the indictment.\u003C\/p\u003E\n\n\u003Cp\u003EHHS-OIG Miami and FBI Miami investigated this case. Southern District of Florida Assistant U.S. Attorney Christopher J. Clark is prosecuting it.\u003C\/p\u003E\n\n\u003Cp\u003EPrior to the charges announced as part of today\u2019s nationwide enforcement action and since its inception in March 2007, the Health Care Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,600 defendants who have collectively billed the Medicare program for approximately $23 billion. In addition to the criminal actions announced today, CMS, working in conjunction with HHS-OIG, announced 28 administrative actions to decrease the presence of fraudulent providers.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003ETelemedicine Fraud Cases\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003EMore than 43 criminal defendants in 11 judicial districts nationwide are charged in cases involving telemedicine: the use of telecommunications technology to provide health care services remotely. It is alleged that these telemedicine defendants filed over $1.1 billion in fraudulent claims.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EThe continued focus on prosecuting health care fraud schemes involving telemedicine reflects the success of the nationwide coordinating role of the Fraud Section\u2019s National Rapid Response Strike Force, the creation of which was announced at the \u003Ca href=\u0022https:\/\/www.justice.gov\/opa\/pr\/national-health-care-fraud-and-opioid-takedown-results-charges-against-345-defendants\u0022\u003E2020 National Health Care Fraud and Opioid Takedown\u003C\/a\u003E. The National Rapid Response Strike Force helped coordinate the prosecution of the telemedicine initiative, Sober Homes initiative, and COVID-19 cases that were announced today. The focus on telemedicine fraud also builds on the telemedicine component of last year\u2019s national takedown and the impact of the \u003Ca href=\u0022https:\/\/www.justice.gov\/opa\/pr\/federal-law-enforcement-action-involving-fraudulent-genetic-testing-results-charges-against\u0022\u003E2019 \u201cOperation Brace Yourself\u201d Telemedicine and Durable Medical Equipment Takedown\u003C\/a\u003E, which resulted in an estimated cost avoidance of more than $1.9 billion in the amount paid by Medicare for orthotic braces in the 20 months following that takedown.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003EHealth Care Fraud Prosecutions in the Southern District of Florida for \u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003EFiscal Year 2020-2021\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe Southern District of Florida is a national leader in health care fraud prosecutions. \u0026nbsp;So far, during the 2020-2021 Fiscal Year (from October 1, 2020 through today), a total of 196 defendants have been charged in the Southern District of Florida with health care fraud-related offenses. \u0026nbsp;It is alleged that approximately $2.2 billion was billed by these defendants and that approximately $488 million was paid. \u0026nbsp;\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u003Ci\u003EA complaint, information or indictment is merely an allegation, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.\u003C\/i\u003E\u003C\/p\u003E\n\n\u003Cp\u003ERelated court documents and information may be found on the website of the District Court for the Southern District of Florida at \u003Ca href=\u0022http:\/\/www.flsd.uscourts.gov\u0022\u003Ewww.flsd.uscourts.gov\u003C\/a\u003E or on \u003Ca href=\u0022http:\/\/pacer.flsd.uscourts.gov\u0022\u003Ehttp:\/\/pacer.flsd.uscourts.gov\u003C\/a\u003E.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003E###\u003C\/b\u003E\u003C\/p\u003E","changed":"\u003Ctime datetime=\u00222021-11-02T18:56:22-04:00\u0022\u003E1635893782\u003C\/time\u003E\n","component":[{"uuid":"7134133d-a27a-4c2c-8c45-cdc1da8e9c1a","name":"USAO - Florida, Southern"}],"created":"\u003Ctime datetime=\u00222021-09-17T15:08:59-04:00\u0022\u003E1631905739\u003C\/time\u003E\n","date":"1631880000","image":"","number":"","teaser":"\u003Cp\u003EOver 50 defendants were charged in the Southern District of Florida in the last six weeks, as part of a nationwide federal law enforcement action to combat health care fraud.\u00a0\u003C\/p\u003E\n","title":"National Health Care Fraud Enforcement Action Results in Charges of Over $308 Million in Intended Loss Against 52 Defendants in the Southern District of Florida","topic":[{"uuid":"6827a162-b783-4ffa-a6c2-596fc9f07e39","name":"COVID-Related Fraud"},{"uuid":"cce5d791-6b0b-462d-9a42-768179164d43","name":"Healthcare Fraud"}],"url":"https:\/\/www.justice.gov\/usao-sdfl\/pr\/national-health-care-fraud-enforcement-action-results-charges-over-308-million-intended","uuid":"34b09d17-40a0-4595-bde9-20c47a813b13"},{"attachment":"","body":"\u003Cp\u003EWASHINGTON \u2013 The Department of Justice announced today criminal charges against 138 defendants, including 42 doctors, nurses, and other licensed medical professionals, in 31 federal districts across the United States for their alleged participation in various healthcare fraud schemes that resulted in approximately $1.4 billion in alleged losses.\u003C\/p\u003E\n\n\u003Cp\u003EThe enforcement action includes criminal charges against four defendants in the Eastern District of Texas involving telemedicine, alleging over $2.9 million in losses.\u003C\/p\u003E\n\n\u003Cp\u003ENationwide, the charges target approximately $1.1 billion in fraud committed using telemedicine (the use of telecommunications technology to provide health care services remotely), $29 million in COVID-19 health care fraud, $133 million connected to substance abuse treatment facilities, or \u201csober homes,\u201d and $160 million connected to other health care fraud and illegal opioid distribution schemes across the country.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cWhile the United States government works to ensure the physical health of the American people through numerous federal programs, the Department of Justice and the Eastern District of Texas work tirelessly to safeguard the financial health of these programs against theft and fraud,\u201d said Acting U.S. Attorney Nicholas J. Ganjei.\u0026nbsp; \u201cThe present enforcement action is not only a decisive blow against fraud and malfeasance in these specific cases, but also serves as a reminder to would-be fraudsters that the federal government is keeping a watchful eye on the use and abuse of taxpayer-funded health care dollars.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThis nationwide enforcement action demonstrates that the Criminal Division is at the forefront of the fight against health care fraud and opioid abuse by prosecuting those who have exploited health care benefit programs and their patients for personal gain,\u201d said Assistant Attorney General Kenneth A. Polite Jr. of the Justice Department\u2019s Criminal Division. \u201cThe charges announced today send a clear deterrent message and should leave no doubt about the department\u2019s ongoing commitment to ensuring the safety of patients and the integrity of health care benefit programs, even amid a continued pandemic.\u201d\u003C\/p\u003E\n\n\u003Cp\u003EToday\u2019s enforcement actions were led and coordinated by the Health Care Fraud Unit of the Criminal Division\u2019s Fraud Section, in conjunction with its Health Care Fraud and Appalachian Regional Prescription Opioid (ARPO) Strike Force program, and its core partners, the U.S. Attorneys\u2019 Offices, the Department of Health and Human Services Office of Inspector General (HHS-OIG), FBI, and the Drug Enforcement Administration (DEA), as part of the department\u2019s ongoing efforts to combat the devastating effects of health care fraud and the opioid epidemic. The Eastern District of Texas worked with the Justice Department\u2019s Criminal Division and agents from HHS-OIG, FBI, DEA, and other federal and state law enforcement agencies in the investigation and prosecution of these cases.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cHealth care fraud targets the vulnerable in our communities, our health care system, and our basic expectation of competent, available care,\u201d said Assistant Director Calvin Shivers of the FBI\u2019s Criminal Investigative Division. \u201cDespite a continued pandemic, the FBI and our law enforcement partners remain dedicated to safeguarding American taxpayers and businesses from the steep cost of health care fraud.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cWe have seen all too often criminals who engage in health care fraud \u2014 stealing from taxpayers while jeopardizing the health of Medicare and Medicaid beneficiaries,\u201d said Deputy Inspector General for Investigations Gary L. Cantrell of HHS-OIG. \u201cToday\u2019s announcement should serve as another warning to individuals who may be considering engaging in such illicit activity: our agency and its law enforcement partners remain unrelenting in our commitment to rooting out fraud, holding bad actors accountable, and protecting the millions of beneficiaries who rely on federal health care programs.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cHolding to account those responsible for health care fraud and diversion of prescription drugs is a priority for DEA,\u201d said DEA Administrator Anne Milgram. \u201cThese fraudulent activities prey on our most vulnerable \u2013 those in pain, the substance-addicted, and even the homeless \u2013 those who are most susceptible to promises of relief, recovery, or a new start. Not only do these schemes profit from desperation, but they often leave their victims even deeper in addiction.\u0026nbsp;We are grateful to our partners who stand with us to keep our communities safer and healthier through our collective efforts to prevent the misuse and over-prescribing of controlled medications.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cEvery dollar saved is critical to the sustainability of our Medicare programs and meeting the needs of seniors and people with disabilities,\u201d said Centers for Medicare \u0026amp; Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure. \u201cCMS has taken actions against 28 providers on behalf of people with Medicare coverage and to protect the Medicare Trust Fund.\u0026nbsp; Actions like this to combat fraud, waste and abuse in our federal programs would not be possible without the successful partnership of Centers for Medicare \u0026amp; Medicaid Services, the Department of Justice and the U.S. Department of Health and Human Services, Office of Inspector General.\u201d\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003ETelemedicine Fraud Cases\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe largest amount of alleged fraud loss charged in connection with the cases announced today \u2013 over $1.1 billion in allegedly false and fraudulent claims submitted by more than 43 criminal defendants in 11 judicial districts nationwide \u2013 relates to schemes involving telemedicine. In the Eastern District of Texas, four defendants were charged with conspiracy to commit illegal remunerations and with substantive counts of illegal remunerations. The conspirators obtained patient information, including protected health information and personally identifiable information, and used the information to create fictitious physicians\u2019 orders.\u0026nbsp; The conspirators then sold the physicians\u2019 orders to each other and to other durable medical equipment providers.\u0026nbsp; Within approximately eight months, the defendants collectively obtained more than $2.9 million in proceeds from the criminal scheme.\u003C\/p\u003E\n\n\u003Cp\u003EThe continued focus on prosecuting health care fraud schemes involving telemedicine reflects the success of the nationwide coordinating role of the Fraud Section\u2019s National Rapid Response Strike Force, the creation of which was announced at the \u003Ca href=\u0022https:\/\/www.justice.gov\/opa\/pr\/national-health-care-fraud-and-opioid-takedown-results-charges-against-345-defendants\u0022\u003E2020 National Health Care Fraud and Opioid Takedown\u003C\/a\u003E. The National Rapid Response Strike Force helped coordinate the prosecution of the telemedicine initiative, Sober Homes initiative, and COVID-19 cases that were announced today. The focus on telemedicine fraud also builds on the telemedicine component of last year\u2019s national takedown and the impact of the \u003Ca href=\u0022https:\/\/www.justice.gov\/opa\/pr\/federal-law-enforcement-action-involving-fraudulent-genetic-testing-results-charges-against\u0022\u003E2019 \u201cOperation Brace Yourself\u201d Telemedicine and Durable Medical Equipment Takedown\u003C\/a\u003E, which resulted in an estimated cost avoidance of more than $1.9 billion in the amount paid by Medicare for orthotic braces in the 20 months following that takedown.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003ECOVID-19 Fraud Cases\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003ENine defendants in the cases announced today are alleged to have engaged in various health care fraud schemes designed to exploit the COVID-19 pandemic, which resulted in the submission of over $29 million in false billings.\u003C\/p\u003E\n\n\u003Cp\u003EThe law enforcement action today also includes criminal charges against five defendants across the country who allegedly engaged in the misuse of Provider Relief Fund monies. The Provider Relief Fund is part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, a federal law enacted March 2020 designed to provide needed medical care to Americans suffering from COVID-19.\u003C\/p\u003E\n\n\u003Cp\u003EThe COVID-19 cases announced today build upon the success of the \u003Ca href=\u0022https:\/\/www.justice.gov\/opa\/pr\/doj-announces-coordinated-law-enforcement-action-combat-health-care-fraud-related-covid-19\u0022\u003ECOVID-19 Health Care Fraud Takedown on May 26\u003C\/a\u003E, a coordinated law enforcement action against 14 defendants in seven judicial districts for over $128 million in false billings. The law enforcement action and the cases announced today were brought in coordination with the Health Care Fraud Unit\u2019s COVID-19 Interagency Working Group, which is chaired by the National Rapid Response Strike Force and organizes efforts to address illegal activity involving health care programs during the pandemic.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003ESober Homes Cases\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe sober homes cases are announced on the one-year anniversary of the first ever national sober homes initiative in 2020, which included charges against more than a dozen criminal defendants in connection with more than $845 million of allegedly false and fraudulent claims for tests and treatments for vulnerable patients seeking treatment for drug and\/or alcohol addiction. The over $133 million in false and fraudulent claims that are additionally alleged in cases announced today reflect the continued effort by the National Rapid Response Strike Force and the Health Care Fraud Unit\u2019s Los Angeles Strike Force, with the participation of the U.S. Attorney\u2019s Offices for the Central District of California and the Southern District of Florida, to prosecute those who participated in illegal kickback and bribery schemes involving the referral of patients to substance abuse treatment facilities; those patients could be subjected to medically unnecessary drug testing \u2013 often billing thousands of dollars for a single test \u2013 and therapy sessions that frequently were not provided, and which resulted in millions of dollars of false and fraudulent claims being submitted to private insurers.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003ECases Involving the Illegal Prescription and\/or Distribution of Opioids and Cases Involving Traditional Health Care Fraud Schemes \u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003E]The cases announced today involving the illegal prescription and\/or distribution of opioids involve 19 defendants, including several charges against medical professionals and others who prescribed over 12 million doses of opioids and other prescription narcotics, while submitting over $14 million in false billings. The cases that fall into more traditional categories of health care fraud include charges against over 60 defendants who allegedly participated in schemes to submit more than $145 million in false and fraudulent claims to Medicare, Medicaid, TRICARE, and private insurance companies for treatments that were medically unnecessary and often never provided.\u003C\/p\u003E\n\n\u003Cp\u003EPrior to the charges announced as part of today\u2019s nationwide enforcement action and since its inception in March 2007, the Health Care Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,600 defendants who have collectively billed the Medicare program for approximately $23 billion. In addition to the criminal actions announced today, CMS, working in conjunction with HHS-OIG, announced 28 administrative actions to decrease the presence of fraudulent providers.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Ci\u003EA complaint, information or indictment is merely an allegation, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.\u003C\/i\u003E\u003C\/p\u003E\n\n\u003Cp\u003ETo view Assistant Attorney General Polite\u2019s remarks, see\u003C\/p\u003E\n\n\u003Cp\u003E\u003Ca href=\u0022https:\/\/www.justice.gov\/opa\/video\/assistant-attorney-general-kenneth-polite-jr-delivers-remarks-health-care-enforcement\u0022\u003Ehttps:\/\/www.justice.gov\/opa\/video\/assistant-attorney-general-kenneth-polite-jr-delivers-remarks-health-care-enforcement\u003C\/a\u003E.\u003C\/p\u003E\n\n\u003Cp\u003E###\u003C\/p\u003E\n\n\u003Cp\u003E\u0026nbsp;\u003C\/p\u003E","changed":"\u003Ctime datetime=\u00222021-09-17T15:28:33-04:00\u0022\u003E1631906913\u003C\/time\u003E\n","component":[{"uuid":"7640bef5-117f-47d2-9226-572020e05213","name":"USAO - Texas, Eastern"}],"created":"\u003Ctime datetime=\u00222021-09-17T15:28:19-04:00\u0022\u003E1631906899\u003C\/time\u003E\n","date":"1631880000","image":"","number":"","teaser":"","title":"National Health Care Fraud Enforcement Action Results in Charges Involving over $1.4 Billion in Alleged Losses","topic":[{"uuid":"cce5d791-6b0b-462d-9a42-768179164d43","name":"Healthcare Fraud"}],"url":"https:\/\/www.justice.gov\/usao-edtx\/pr\/national-health-care-fraud-enforcement-action-results-charges-involving-over-14-billion","uuid":"46eaf312-8142-4134-8165-6321d2d27350"},{"attachment":"","body":"\u003Cp\u003EPHOENIX, Ariz. \u2013 The Department of Justice announced today criminal charges against 138 defendants, including 42 doctors, nurses, and other licensed medical professionals, in 31 federal districts across the United States for their alleged participation in various healthcare fraud schemes that resulted in approximately $1.4 billion in alleged losses.\u003C\/p\u003E\n\n\u003Cp\u003EThe enforcement action includes criminal charges against two defendants here in the District of Arizona, involving health care fraud, for over $1.2 million in losses.\u003C\/p\u003E\n\n\u003Cp\u003ENationwide, the charges target approximately $1.1 billion in fraud committed using telemedicine (the use of telecommunications technology to provide health care services remotely), $29 million in COVID-19 health care fraud, $133 million connected to substance abuse treatment facilities, or \u201csober homes,\u201d and $160 million connected to other health care fraud and illegal opioid distribution schemes across the country.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cToday\u2019s announcement highlights law enforcement\u2019s ongoing, nationwide commitment to eradicate health care fraud,\u201d said Acting United States Attorney Glenn B. McCormick. \u201cAnyone tempted by greed to cheat taxpayers, abuse our healthcare system, and place vulnerable people at risk through health care fraud will be discovered, disgorged of ill-gotten gains, face loss of licensure, and time in prison. We are committed to work alongside our partners in law enforcement to protect the integrity of our health care system.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThis nationwide enforcement action demonstrates that the Criminal Division is at the forefront of the fight against health care fraud and opioid abuse by prosecuting those who have exploited health care benefit programs and their patients for personal gain,\u201d said Assistant Attorney General Kenneth A. Polite Jr. of the Justice Department\u2019s Criminal Division. \u201cThe charges announced today send a clear deterrent message and should leave no doubt about the department\u2019s ongoing commitment to ensuring the safety of patients and the integrity of health care benefit programs, even amid a continued pandemic.\u201d\u003C\/p\u003E\n\n\u003Cp\u003EToday\u2019s enforcement actions were led and coordinated by the Health Care Fraud Unit of the Criminal Division\u2019s Fraud Section, in conjunction with its Health Care Fraud and Appalachian Regional Prescription Opioid (ARPO) Strike Force program, and its core partners, the U.S. Attorneys\u2019 Offices, the Department of Health and Human Services Office of Inspector General (HHS-OIG), FBI, and the Drug Enforcement Administration (DEA), as part of the department\u2019s ongoing efforts to combat the devastating effects of health care fraud and the opioid epidemic. The District of Arizona worked with the Justice Department\u2019s Criminal Division and agents from HHS-OIG, FBI, DEA, and other federal and state law enforcement agencies in the investigation and prosecution of these cases.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cHealth care fraud targets the vulnerable in our communities, our health care system, and our basic expectation of competent, available care,\u201d said Assistant Director Calvin Shivers of the FBI\u2019s Criminal Investigative Division. \u201cDespite a continued pandemic, the FBI and our law enforcement partners remain dedicated to safeguarding American taxpayers and businesses from the steep cost of health care fraud.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cWe have seen all too often criminals who engage in health care fraud \u2014 stealing from taxpayers while jeopardizing the health of Medicare and Medicaid beneficiaries,\u201d said Deputy Inspector General for Investigations Gary L. Cantrell of HHS-OIG. \u201cToday\u2019s announcement should serve as another warning to individuals who may be considering engaging in such illicit activity: our agency and its law enforcement partners remain unrelenting in our commitment to rooting out fraud, holding bad actors accountable, and protecting the millions of beneficiaries who rely on federal health care programs.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cHolding to account those responsible for health care fraud and diversion of prescription drugs is a priority for DEA,\u201d said DEA Administrator Anne Milgram. \u201cThese fraudulent activities prey on our most vulnerable \u2013 those in pain, the substance-addicted, and even the homeless \u2013 those who are most susceptible to promises of relief, recovery, or a new start. Not only do these schemes profit from desperation, but they often leave their victims even deeper in addiction.\u0026nbsp;We are grateful to our partners who stand with us to keep our communities safer and healthier through our collective efforts to prevent the misuse and over-prescribing of controlled medications.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cEvery dollar saved is critical to the sustainability of our Medicare programs and meeting the needs of seniors and people with disabilities,\u201d said Centers for Medicare \u0026amp; Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure. \u201cCMS has taken actions against 28 providers on behalf of people with Medicare coverage and to protect the Medicare Trust Fund.\u0026nbsp; Actions like this to combat fraud, waste and abuse in our federal programs would not be possible without the successful partnership of Centers for Medicare \u0026amp; Medicaid Services, the Department of Justice and the U.S. Department of Health and Human Services, Office of Inspector General.\u201d\u0026nbsp;\u003Cbr\u003E\n\u003Cbr\u003E\n\u003Cb\u003ETelemedicine Fraud Cases\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe largest amount of alleged fraud loss charged in connection with the cases announced today \u2013 over $1.1 billion in allegedly false and fraudulent claims submitted by more than 43 criminal defendants in 11 judicial districts nationwide \u2013 relates to schemes involving telemedicine.\u003C\/p\u003E\n\n\u003Cp\u003EThe continued focus on prosecuting health care fraud schemes involving telemedicine reflects the success of the nationwide coordinating role of the Fraud Section\u2019s National Rapid Response Strike Force, the creation of which was announced at the \u003Ca href=\u0022https:\/\/www.justice.gov\/opa\/pr\/national-health-care-fraud-and-opioid-takedown-results-charges-against-345-defendants\u0022\u003E2020 National Health Care Fraud and Opioid Takedown\u003C\/a\u003E. The National Rapid Response Strike Force helped coordinate the prosecution of the telemedicine initiative, Sober Homes initiative, and COVID-19 cases that were announced today. The focus on telemedicine fraud also builds on the telemedicine component of last year\u2019s national takedown and the impact of the \u003Ca href=\u0022https:\/\/www.justice.gov\/opa\/pr\/federal-law-enforcement-action-involving-fraudulent-genetic-testing-results-charges-against\u0022\u003E2019 \u201cOperation Brace Yourself\u201d Telemedicine and Durable Medical Equipment Takedown\u003C\/a\u003E, which resulted in an estimated cost avoidance of more than $1.9 billion in the amount paid by Medicare for orthotic braces in the 20 months following that takedown.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003ECOVID-19 Fraud Cases\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003ENine defendants in the cases announced today are alleged to have engaged in various health care fraud schemes designed to exploit the COVID-19 pandemic, which resulted in the submission of over $29 million in false billings.\u003C\/p\u003E\n\n\u003Cp\u003EThe law enforcement action today also includes criminal charges against five defendants across the country who allegedly engaged in the misuse of Provider Relief Fund monies. The Provider Relief Fund is part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, a federal law enacted March 2020 designed to provide needed medical care to Americans suffering from COVID-19.\u003C\/p\u003E\n\n\u003Cp\u003EThe COVID-19 cases announced today build upon the success of the \u003Ca href=\u0022https:\/\/www.justice.gov\/opa\/pr\/doj-announces-coordinated-law-enforcement-action-combat-health-care-fraud-related-covid-19\u0022\u003ECOVID-19 Health Care Fraud Takedown on May 26\u003C\/a\u003E, a coordinated law enforcement action against 14 defendants in seven judicial districts for over $128 million in false billings. The law enforcement action and the cases announced today were brought in coordination with the Health Care Fraud Unit\u2019s COVID-19 Interagency Working Group, which is chaired by the National Rapid Response Strike Force and organizes efforts to address illegal activity involving health care programs during the pandemic.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003ESober Homes Cases\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe sober homes cases are announced on the one-year anniversary of the first ever national sober homes initiative in 2020, which included charges against more than a dozen criminal defendants in connection with more than $845 million of allegedly false and fraudulent claims for tests and treatments for vulnerable patients seeking treatment for drug and\/or alcohol addiction. The over $133 million in false and fraudulent claims that are additionally alleged in cases announced today reflect the continued effort by the National Rapid Response Strike Force and the Health Care Fraud Unit\u2019s Los Angeles Strike Force, with the participation of the U.S. Attorney\u2019s Offices for the Central District of California and the Southern District of Florida, to prosecute those who participated in illegal kickback and bribery schemes involving the referral of patients to substance abuse treatment facilities; those patients could be subjected to medically unnecessary drug testing \u2013 often billing thousands of dollars for a single test \u2013 and therapy sessions that frequently were not provided, and which resulted in millions of dollars of false and fraudulent claims being submitted to private insurers.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003ECases Involving the Illegal Prescription and\/or Distribution of Opioids and Cases Involving Traditional Health Care Fraud Schemes \u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe cases announced today involving the illegal prescription and\/or distribution of opioids involve 19 defendants, including several charges against medical professionals and others who prescribed over 12 million doses of opioids and other prescription narcotics, while submitting over $14 million in false billings. The cases that fall into more traditional categories of health care fraud include charges against over 60 defendants who allegedly participated in schemes to submit more than $145 million in false and fraudulent claims to Medicare, Medicaid, TRICARE, and private insurance companies for treatments that were medically unnecessary and often never provided.\u003C\/p\u003E\n\n\u003Cp\u003EIn the District of Arizona, Dale and Zoila Henson, both of Chandler, Arizona, were indicted earlier this year on 58 counts related to fraudulently billing the Arizona Healthcare Cost Containment System and for fraud involving receipt of COVID-19 Economic Injury Disaster Loan Funds. The couple is alleged to have submitted $1.2 million in fraudulent bills to AHCCS over a 9-month period in 2019-2020. They Hensons are also alleged to have lied in their applications for COVID-19 pandemic-related loans and used the proceeds of the loan funds for personal expenses, such as the purchase of a residence in Mexico.\u003C\/p\u003E\n\n\u003Cp\u003EMore details are available in the District\u2019s prior press release: \u003Ca href=\u0022https:\/\/www.justice.gov\/usao-az\/pr\/chandler-couple-arrested-ahcccs-fraud-and-pandemic-loan-fraud\u0022\u003Ehttps:\/\/www.justice.gov\/usao-az\/pr\/chandler-couple-arrested-ahcccs-fraud-and-pandemic-loan-fraud\u003C\/a\u003E\u003C\/p\u003E\n\n\u003Cp\u003EPrior to the charges announced as part of today\u2019s nationwide enforcement action and since its inception in March 2007, the Health Care Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,600 defendants who have collectively billed the Medicare program for approximately $23 billion. In addition to the criminal actions announced today, CMS, working in conjunction with HHS-OIG, announced 28 administrative actions to decrease the presence of fraudulent providers.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Ci\u003EA complaint, information or indictment is merely an allegation, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.\u003C\/i\u003E\u003C\/p\u003E\n\n\u003Cp\u003ETo view Assistant Attorney General Polite\u2019s remarks, see: \u003Ca href=\u0022https:\/\/www.justice.gov\/opa\/video\/assistant-attorney-general-kenneth-polite-jr-delivers-remarks-health-care-enforcement\u0022\u003Ehttps:\/\/www.justice.gov\/opa\/video\/assistant-attorney-general-kenneth-polite-jr-delivers-remarks-health-care-enforcement\u003C\/a\u003E.\u003Cbr\u003E\n\u003Cbr\u003E\nRELEASE NUMBER:\u0026nbsp;\u0026nbsp;\u0026nbsp; 2021-061_Health Care Fraud NEA\u003C\/p\u003E\n\n\u003Cp\u003E# # #\u003C\/p\u003E\n\n\u003Cp\u003EFor more information on the U.S. Attorney\u2019s Office, District of Arizona, visit \u003Ca href=\u0022http:\/\/www.justice.gov\/usao\/az\/\u0022\u003Ehttp:\/\/www.justice.gov\/usao\/az\/\u003C\/a\u003E\u003Cbr\u003E\n\u003Ci\u003EFollow the U.S. Attorney\u2019s Office, District of Arizona, on Twitter \u003C\/i\u003E\u003Ca href=\u0022https:\/\/twitter.com\/USAO_AZ\u0022\u003E\u003Ci\u003E@USAO_AZ\u003C\/i\u003E\u003C\/a\u003E\u003Ci\u003E for the latest news.\u003C\/i\u003E\u003C\/p\u003E\n\n\u003Cp\u003E\u0026nbsp;\u003C\/p\u003E","changed":"\u003Ctime datetime=\u00222021-09-17T17:04:28-04:00\u0022\u003E1631912668\u003C\/time\u003E\n","component":[{"uuid":"d139d6e1-c7f0-481e-8385-3a94932f1a53","name":"USAO - Arizona"}],"created":"\u003Ctime datetime=\u00222021-09-17T16:57:37-04:00\u0022\u003E1631912257\u003C\/time\u003E\n","date":"1631880000","image":"","number":"2021-061_Heath Care Fraud NEA","teaser":"","title":"National Health Care Fraud Enforcement Action Results in Charges Involving over $1.4 Billion in Alleged Losses","topic":[{"uuid":"6827a162-b783-4ffa-a6c2-596fc9f07e39","name":"COVID-Related Fraud"},{"uuid":"cce5d791-6b0b-462d-9a42-768179164d43","name":"Healthcare Fraud"}],"url":"https:\/\/www.justice.gov\/usao-az\/pr\/national-health-care-fraud-enforcement-action-results-charges-involving-over-14-billion","uuid":"8cb4e979-fa4f-480e-ae8a-515a5088c1e3"},{"attachment":"","body":"\u003Cp\u003E\u003Cb\u003EFor Further Information, Contact:\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003EAssistant U. S. Attorney Valerie Chu (619) 546-6750\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003ESAN DIEGO \u2013 A strategically coordinated, six-week nationwide federal law enforcement action has resulted in criminal charges against 138 defendants, including 42 doctors, nurses, and other licensed medical professionals, in 31 federal districts across the United States for their alleged participation in various health care fraud schemes that resulted in approximately $1.4 billion in alleged losses.\u003C\/p\u003E\n\n\u003Cp\u003EThe enforcement action includes criminal charges against four defendants here in the Southern District of California, involving more than $129 million in intended losses.\u003C\/p\u003E\n\n\u003Cp\u003ENationwide, this action includes more than $1.1 billion in fraud committed using telemedicine, more than $29 million in COVID-19 health care fraud, more than $133 million connected to substance abuse treatment facilities, or \u201csober homes,\u201d and more than $160 million connected to other health care fraud and illegal opioid distribution schemes across the country\u003C\/p\u003E\n\n\u003Cp\u003E\u0022Federal dollars devoted to care for the sick and suffering in our community should not be diverted to line the pockets of greedy opportunists,\u201d said Acting U.S. Attorney Randy Grossman. \u201cNow more than ever, we recognize the importance of our health care system and the important federal programs that care for elderly and Americans with disabilities.\u0022\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThis nationwide enforcement action demonstrates that the Criminal Division is at the forefront of the fight against health care fraud and opioid abuse by prosecuting those who have exploited health care benefit programs and their patients for personal gain,\u201d said Assistant Attorney General Kenneth A. Polite Jr. of the Justice Department\u2019s Criminal Division. \u201cThe coordinated law enforcement actions announced today send a clear deterrent message and should leave no doubt about the department\u2019s ongoing commitment to ensuring the safety of patients and the integrity of health care benefit programs, even amid a continued pandemic. I am proud of the hard work and dedication of those throughout law enforcement who are working to safeguard our health care system and our nation.\u201d\u003C\/p\u003E\n\n\u003Cp\u003EToday\u2019s enforcement actions were led and coordinated by the Health Care Fraud Unit of the Criminal Division\u2019s Fraud Section, in conjunction with its Health Care Fraud and Appalachian Regional Prescription Opioid (ARPO) Strike Force program, and its core partners, the U.S. Attorneys\u2019 Offices, the Department of Health and Human Services Office of Inspector General (HHS-OIG), FBI, and the Drug Enforcement Administration (DEA), as part of the department\u2019s ongoing efforts to combat the devastating effects of health care fraud and the opioid epidemic. The Southern District of California worked with the Justice Department\u2019s Criminal Division and agents from HHS-OIG, FBI, and DEA in the investigation and prosecution of these cases.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003ETelemedicine Fraud Cases\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe largest amount of alleged fraud loss charged in connection with the cases announced today \u2013 over $1.1 billion in allegedly false and fraudulent claims submitted by more than 50 criminal defendants in 11 judicial districts nationwide \u2013 relates to schemes involving telemedicine: the use of telecommunications technology to provide health care services remotely.\u003C\/p\u003E\n\n\u003Cp\u003EThe continued focus on prosecuting health care fraud schemes involving telemedicine reflects the success of the nationwide coordinating role played by the Fraud Section\u2019s National Rapid Response Strike Force, the creation of which was announced at the 2020 National Health Care Fraud and Opioid Takedown. The National Rapid Response Strike Force helped coordinate the prosecution of the telemedicine initiative, Sober Homes initiative, and COVID-19 cases that were announced today. The focus on telemedicine fraud also builds on the telemedicine component of last year\u2019s national takedown and the impact of the 2019 \u201cOperation Brace Yourself\u201d Telemedicine and Durable Medical Equipment Takedown, which resulted in an estimated cost avoidance of more than $1.5 billion in the amount paid by Medicare for orthotic braces in the 17 months following that takedown.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003ECOVID-19 Fraud Cases\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003ENine defendants in the cases announced today are alleged to have engaged in various health care fraud schemes designed to exploit the COVID-19 pandemic, which resulted in the submission of over $29 million in false billings.\u003C\/p\u003E\n\n\u003Cp\u003EIn the Southern District of California, Roselia Kubeck and Rosario Gonzalez pleaded guilty to having approached residents of senior complexes in El Centro and Calexico, California, who were Medicare beneficiaries, and offering COVID-19 screening tests for the residents. The defendants knew at the time that the tests would not actually test for COVID-19 but would be a general respiratory pathogens screening panel that tested for the presence of several kinds of respiratory pathogens.\u0026nbsp; They also took urine samples from the Medicare beneficiaries without explaining that the urine samples were not necessary to conduct a COVID-19 test.\u0026nbsp; The defendants then completed requisition forms for tests on the nasal swabs and urine samples, and inaccurately indicated on the forms that the beneficiaries needed the respiratory tests because they were suffering from acute respiratory infections and needed urine tests because the beneficiaries were long-term users of opiates or had urinary tract infections.\u0026nbsp; The laboratories that performed the tests subsequently submitted inaccurate and medically unnecessary claims to Medicare based on the inaccurate diagnoses that the defendants put on the requisition forms.\u003C\/p\u003E\n\n\u003Cp\u003EThe law enforcement action today also includes criminal charges against five defendants across the country related to the misuse of Provider Relief Fund monies. The Provider Relief Fund is part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, a federal law enacted March 2020 designed to provide needed medical care to Americans suffering from COVID-19.\u003C\/p\u003E\n\n\u003Cp\u003EThe COVID-19 cases announced today build upon the success of the COVID-19 Health Care Fraud Takedown on May 26, a coordinated law enforcement action against 14 defendants in seven judicial districts for over $128 million in false billings. The law enforcement action and the cases announced today were brought in coordination with the Health Care Fraud Unit\u2019s COVID-19 Interagency Working Group, which is chaired by the National Rapid Response Strike Force and organizes efforts to address illegal activity involving health care programs during the pandemic.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003ESober Homes Cases\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe sober homes cases are announced on the one-year anniversary of the first ever national sober homes initiative in 2020, which included charges against more than a dozen criminal defendants in connection with more than $845 million of allegedly false and fraudulent claims for tests and treatments for vulnerable patients seeking treatment for drug and\/or alcohol addiction. The over $133 million in false and fraudulent claims that are additionally alleged in cases announced today reflect the continued effort by the National Rapid Response Strike Force and the Health Care Fraud Unit\u2019s Los Angeles Strike Force, with the participation of the U.S. Attorney\u2019s Offices for the Central District of California and the Southern District of Florida, to prosecute those who participated in illegal kickback and bribery schemes involving the referral of patients to substance abuse treatment facilities; those patients could be subjected to medically unnecessary drug testing \u2013 often billing thousands of dollars for a single test \u2013 and therapy sessions that frequently were not provided, and which resulted in millions of dollars of false and fraudulent claims being submitted to private insurers.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003ECases Involving the Illegal Prescription and\/or Distribution of Opioids and Cases Involving Traditional Health Care Fraud Schemes \u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe cases announced today involving the illegal prescription and\/or distribution of opioids involve more than 13 defendants, including several charges against medical professionals and others who prescribed over seven million doses of opioids and other prescription narcotics. The cases that fall into more traditional categories of health care fraud include charges against 67 defendants who allegedly participated in schemes to submit more than $160 million in false and fraudulent claims to Medicare, Medicaid, TRICARE, and private insurance companies for treatments that were medically unnecessary and often never provided.\u003C\/p\u003E\n\n\u003Cp\u003EIn the Southern District of California, Ronald Charles Green Jr. and Melinda Elizabeth Green were charged with conspiring to defraud TRICARE and Medicare out of more than $129 million.\u0026nbsp; In connection with a compounding pharmacy fraud, the defendants allegedly engaged in a scheme involving the submission of false and fraudulent claims to TRICARE for expensive and medically unnecessary pain creams, scar creams and multi-vitamins, which were billed through compound pharmacies. Thereafter, the defendants allegedly launched multiple durable medical equipment companies, and carried out a scheme to defraud Medicare through the submission of false and fraudulent claims for expensive durable medical equipment which were induced through a system of illegal kickbacks. Out of the $129 million in claims, Medicare paid the defendants\u2019 companies more than $69 million.\u0026nbsp; \u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EPrior to the charges announced as part of today\u2019s nationwide enforcement action and since its inception in March 2007, the Health Care Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,600 defendants who have collectively billed the Medicare program for approximately $23 billion. In addition to the criminal actions announced today, CMS, working in conjunction with HHS-OIG, announced more than 15 payment suspensions to decrease the presence of fraudulent providers.\u003C\/p\u003E\n\n\u003Cp\u003ETo view Assistant Attorney General Polite\u2019s remarks, see\u0026nbsp;\u003Ca href=\u0022https:\/\/www.justice.gov\/opa\/video\/assistant-attorney-general-kenneth-polite-jr-delivers-remarks-health-care-enforcement\u0022\u003Ehttps:\/\/www.justice.gov\/opa\/video\/assistant-attorney-general-kenneth-polite-jr-delivers-remarks-health-care-enforcement\u003C\/a\u003E.\u003C\/p\u003E\n\n\u003Cp\u003E\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EThe Southern District of California cases discussed herein were prosecuted by Assistant U.S. Attorneys Valerie Chu and Kevin Larsen and investigated by the Federal Bureau of Investigation, the Office of Inspector General for the United States Department of Health and Human Services, and the Defense Criminal Investigative Service. Grossman thanked the prosecutors and law enforcement agencies for working hard to achieve justice in these matters.\u003C\/p\u003E\n\n\u003Cp\u003E\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EOn May 17, 2021, the Attorney General established the COVID-19 Fraud Enforcement Task Force to marshal the resources of the Department of Justice in partnership with agencies across government to enhance efforts to combat and prevent pandemic-related fraud. The Task Force bolsters efforts to investigate and prosecute the most culpable domestic and international criminal actors and assists agencies tasked with administering relief programs to prevent fraud by, among other methods, augmenting and incorporating existing coordination mechanisms, identifying resources and techniques to uncover fraudulent actors and their schemes, and sharing and harnessing information and insights gained from prior enforcement efforts. For more information on the Department\u2019s response to the pandemic, please visit https:\/\/www.justice.gov\/coronavirus\u003C\/p\u003E\n\n\u003Cp\u003E\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EAnyone with information about allegations of attempted fraud involving COVID-19 can report it by calling the Department of Justice\u2019s National Center for Disaster Fraud (NCDF) Hotline at 866-720-5721 or via the NCDF Web Complaint Form at: \u003Ca href=\u0022https:\/\/www.justice.gov\/disaster-fraud\/ncdf-disaster-complaint-form\u0022\u003Ehttps:\/\/www.justice.gov\/disaster-fraud\/ncdf-disaster-complaint-form\u003C\/a\u003E.\u003C\/p\u003E\n\n\u003Cp\u003E*A complaint, information or indictment is merely an allegation, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.\u003C\/p\u003E","changed":"\u003Ctime datetime=\u00222021-09-17T18:38:29-04:00\u0022\u003E1631918309\u003C\/time\u003E\n","component":[{"uuid":"fdad26ae-a50e-41f0-90c6-0e0f10c69b9c","name":"USAO - California, Southern"}],"created":"\u003Ctime datetime=\u00222021-09-17T18:36:18-04:00\u0022\u003E1631918178\u003C\/time\u003E\n","date":"1631880000","image":"","number":"CAS21-0917-FraudEnforcement","teaser":"","title":"National Health Care Fraud Enforcement Action Results in Charges Involving over $1.4 Billion in Alleged Losses","topic":[{"uuid":"cce5d791-6b0b-462d-9a42-768179164d43","name":"Healthcare Fraud"}],"url":"https:\/\/www.justice.gov\/usao-sdca\/pr\/national-health-care-fraud-enforcement-action-results-charges-involving-over-14-billion","uuid":"3fae12e8-a120-4524-9516-1f5cd08df061"},{"attachment":"","body":"\u003Cp\u003EThe Justice Department, together with federal and state law enforcement partners, announced today a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 78 defendants for their alleged participation in health care fraud and opioid abuse schemes that included over $2.5 billion in alleged fraud.\u003C\/p\u003E\n\n\u003Cp\u003EThe defendants allegedly defrauded programs entrusted for the care of the elderly and disabled, and, in some cases, used the proceeds of the schemes to purchase luxury items, including exotic automobiles, jewelry, and yachts. In connection with the enforcement action, the Department seized or restrained millions of dollars in cash, automobiles, and real estate.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThese enforcement actions, including against one of the largest health care fraud schemes ever prosecuted by the Justice Department, represent our intensified efforts to combat fraud and prosecute the individuals who profit from it,\u201d said Attorney General Merrick B. Garland. \u201cThe Justice Department will find and bring to justice criminals who seek to defraud Americans and steal from taxpayer-funded programs.\u201d\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThis nationwide enforcement action demonstrates that the Criminal Division is committed to fighting health care fraud and opioid abuse by prosecuting those who allegedly exploit patients and health care benefit programs for personal gain,\u201d said Assistant Attorney General Kenneth A. Polite, Jr. of the Justice Department\u2019s Criminal Division. \u201cToday\u2019s announcement includes some of the largest and most complex cases that the Department has prosecuted, and demonstrates the Department\u2019s commitment to seeking justice for those at all levels of the healthcare industry who put profits above patient care, from professionals in doctors\u2019 offices to executives in corporate boardrooms.\u201d\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u201cHealth care fraud is a complex and ever-evolving threat that negatively impacts the American people,\u201d said Assistant Director Luis Quesada of the FBI\u2019s Criminal Investigative Division. \u201cToday\u2019s nationwide coordinated law enforcement action is a testament to the tenacity of the FBI and our partners, as well as our combined efforts to pursue anyone who conspires to exploit our health care system for financial gain.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cPatients trust federal health care programs to provide high quality care. When bad actors steal from these programs, they hurt patients,\u201d said Inspector General Christi A. Grimm of the Department of Health and Human Services Office of the Inspector General (HHS-OIG). \u201cHHS-OIG is dedicated to protecting federal health care programs and putting patients first. Thank you to our law enforcement partners, especially the Medicaid Fraud Control Units, that participated in this effort.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cAt the Drug Enforcement Administration (DEA), we are committed to protecting the safety and health of all Americans,\u201d said DEA Administrator Anne Milgram. \u201cWhen individuals divert addictive opioid medications for personal gain, they are knowingly putting Americans at risk, all too often causing harm and even death. DEA is committed to taking decisive action to hold accountable anyone who participates in these dangerous schemes.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThe Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) provides community health care to family members of our nation\u2019s disabled or deceased veterans, and the defendants\u2019 alleged criminal actions resulted in a multibillion-dollar fraud scheme that puts those benefits at risk and pilfers significant taxpayer funds,\u201d said Inspector General Michael J. Missal of the Department of Veterans Affairs Office of Inspector General (VA-OIG). \u201cThe VA-OIG\u2019s continued oversight of VA\u2019s multiple healthcare programs, including CHAMPVA, is one of the agency\u2019s highest priorities. We thank our outstanding law enforcement partners for their efforts in this investigation.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cu\u003ETelemedicine Fraud \u003C\/u\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe enforcement action included charges against 11 defendants in connection with the submission of over $2 billion in fraudulent claims resulting from telemedicine schemes. In a case involving the alleged organizers of one of the largest health care fraud schemes ever prosecuted, an indictment in the Southern District of Florida alleges that the chief executive officer (CEO), former CEO, and Vice President of Business Development of purported software and services companies conspired to generate and sell templated doctors\u2019 orders for orthotic braces and pain creams in exchange for kickbacks and bribes. The conspiracy allegedly resulted in the submission of $1.9 billion in false and fraudulent claims to Medicare and other government insurers for orthotic braces, prescription skin creams, and other items that were medically unnecessary and ineligible for Medicare reimbursement.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EAs part of the alleged conspiracy, individuals in a massive telemarketing operation, located in the United States and abroad, targeted the elderly and disabled with direct mail, television advertisements, and other forms of advertising to induce them to contact offshore boiler-rooms staffed by individuals who \u201cup-sold\u201d the elderly and disabled on unnecessary medical equipment and prescriptions. According to the indictment, the software platform that the defendants allegedly operated was actually a conduit for these telemarketers to coordinate the payment of illegal kickbacks and bribes to telemedicine companies to obtain doctors\u2019 orders for Medicare beneficiaries. The defendants allegedly programmed the software platform to generate false and fraudulent orders for telemedicine practitioners to sign and obstruct Medicare investigations by concealing that the interactions with beneficiaries had occurred remotely using telemedicine. The program-generated orders falsified certifications that the telemedicine doctors had examined the beneficiaries in person, and falsified diagnostic testing that Medicare required for brace orders.\u0026nbsp;After the original CEO sold the company in a corporate acquisition, the new corporate leadership allegedly chose to continue the pre-existing fraud scheme.\u003C\/p\u003E\n\n\u003Cp\u003EIn another telemedicine fraud case, in the Eastern District of Washington, a licensed physician was charged for signing more than 2800 fraudulent orders for orthotic braces, including for patients whose limbs had already been amputated. As alleged, the physician took less than 40 seconds to review and sign each order.\u003C\/p\u003E\n\n\u003Cp\u003EThe cases announced today build on earlier telemedicine enforcement actions involving over $10.1 billion in fraud. The April 2019 Operation Brace Yourself Telemedicine and Durable Medical Equipment Takedown alone resulted in an estimated cost avoidance of more than $1.9 billion in the amount Medicare paid for orthotic braces in the 20 months following that enforcement action, preserving the Medicare trust fund for necessary medical care.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cu\u003EPharmaceutical Fraud\u003C\/u\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe enforcement action also included charges against 10 defendants in connection with the submission of over $370 million in fraudulent claims submitted in connection with prescription drugs. In one case announced today, the owner and corporate officer of a pharmaceutical wholesale distribution company was charged for an alleged $150 million fraud scheme in which the company purchased illegally diverted prescription HIV medication, and then marketed and resold the medication by falsely representing that the company acquired it through legitimate channels. The defendant allegedly purchased the diverted medication at a substantial discount from individuals who obtained the drugs primarily through illegal \u201cbuyback\u201d schemes in which they paid HIV patients cash for their expensive HIV medication and repackaged those pills for resale. To cover up their scheme, the defendant and others falsified labeling and product tracing documentation to make it appear legitimate. Pharmacies purchased the misbranded medications, dispensed them to patients, and billed them to health care benefit programs, all while the defendants reaped substantial illegal profits.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EIn a related case, on June 15, an individual in the Southern District of Florida was sentenced to 15 years in prison for his role in this nationwide scheme. According to court documents, the defendant illegally acquired large quantities of prescription drugs from patients for whom the drugs had been prescribed but not yet consumed. The defendant and others then repackaged the drugs and sold them to wholesale companies. In some instances, the medication that the defendant sold contained the wrong medication, broken pills, and even pebbles, leading to complaints by pharmacies. The defendant used his share of the proceeds to purchase luxury goods, including a $280,000 Lamborghini, a $220,000 Mercedes, and three boats.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cu\u003EOpioid Distribution and Other Types of Health Care Fraud\u003C\/u\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe charges also targeted over $150 million in false billings submitted in connection with other types of health care fraud, including the illegal distribution of opioids and clinical laboratory testing fraud. Today\u2019s enforcement action includes charges against 24 physicians and other licensed medical professionals who lined their own pockets, including doctors who allegedly put their patients at risk by illegally providing them with opioids they did not need. The charges also include cases where healthcare companies, physicians, and other providers paid cash kickbacks to patient recruiters and beneficiaries in return for patient information, so that the providers could submit fraudulent bills for Medicare reimbursement.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EThe Center for Program Integrity of the Centers for Medicare \u0026amp; Medicaid Services (CPI\/CMS) separately announced today that it took adverse administrative actions in the last six months against 90 medical providers for their alleged involvement in health care fraud.\u003C\/p\u003E\n\n\u003Cp\u003EPrincipal Assistant Deputy Chief Jacob Foster and Acting Assistant Chief Rebecca Yuan of the National Rapid Response Strike Force of the Criminal Division\u2019s Fraud Section led and coordinated today\u2019s enforcement action. The Health Care Fraud Unit\u2019s Strike Forces in Brooklyn, Dallas, Detroit, the Gulf Coast, Houston, Los Angeles, Miami, Newark, and Tampa; the Health Care Fraud Unit\u2019s National Rapid Response Strike Force; the U.S. Attorneys\u2019 Offices for the Middle District of Florida, Southern District of Florida, Southern District of Georgia, District of Idaho, Western District of Kentucky, Eastern District of Louisiana, Middle District of Louisiana, District of New Jersey, Eastern District of New York, Southern District of Ohio, District of South Carolina, Southern District of Texas, Eastern District of Washington, and Eastern District of Wisconsin; and the State Attorney Generals\u2019 Offices for Indiana, New York, and Pennsylvania are prosecuting these cases, with assistance from the Health Care Fraud Unit\u2019s Data Analytics Team. Descriptions of cases involved in today\u2019s enforcement action are available on the Department\u2019s website at \u003Ca href=\u0022https:\/\/www.justice.gov\/criminal-fraud\/health-care-fraud-unit\/2023-national-hcf-case-summaries\u0022\u003Ewww.justice.gov\/criminal-fraud\/health-care-fraud-unit\/2023-national-hcf-case-summaries\u003C\/a\u003E.\u003C\/p\u003E\n\n\u003Cp\u003EIn addition to the FBI, HHS-OIG, DEA, and CMS\/CPI, State Medicaid Fraud Control Units, HSI, FDA, IRS-CI, VA-OIG, USPS-OIG, FDIC-OIG, OPM-OIG, Amtrak-OIG, and other federal and state law enforcement agencies participated in the operation.\u003C\/p\u003E\n\n\u003Cp\u003EThe Fraud Section leads the Criminal Division\u2019s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, comprised of 15 strike forces operating in 25 federal districts, has charged more than 5,000 defendants who collectively have billed federal health care programs and private insurers more than $24 billion. More information can be found at \u003Ca href=\u0022https:\/\/www.justice.gov\/criminal-fraud\/health-care-fraud-unit\u0022\u003Ewww.justice.gov\/criminal-fraud\/health-care-fraud-unit\u003C\/a\u003E.\u003C\/p\u003E\n\n\u003Cp\u003EThe Fraud Section uses the Victim Notification System to provide victims with case information and updates related to this case. Victims with questions may contact the Fraud Section\u2019s Victim Assistance Unit by calling the Victim Assistance phone line at 1-888-549-3945 or by emailing \u003Ca href=\u0022mailto:victimassistance.fraud@usdoj.gov\u0022\u003Evictimassistance.fraud@usdoj.gov\u003C\/a\u003E. To learn more about victims\u2019 rights, please visit \u003Ca href=\u0022http:\/\/www.justice.gov\/criminal-vns\/victim-rights-derechos-de-las-v-ctimas\u0022\u003Ewww.justice.gov\/criminal-vns\/victim-rights-derechos-de-las-v-ctimas\u003C\/a\u003E, and for further information for victims about new federal charges in connection with the HIV scheme, please visit \u003Ca href=\u0022http:\/\/www.justice.gov\/criminal-vns\/case\/united-states-v-steven-diamantstein\u0022\u003Ewww.justice.gov\/criminal-vns\/case\/united-states-v-steven-diamantstein\u003C\/a\u003E.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cem\u003EA complaint, information, or indictment is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.\u003C\/em\u003E\u003C\/p\u003E","changed":"\u003Ctime datetime=\u00222025-02-06T12:31:05-05:00\u0022\u003E1738863065\u003C\/time\u003E\n","component":[{"uuid":"e99b9547-7d65-42c6-9404-68fab0db9543","name":"Office of the Attorney General"},{"uuid":"46370d9f-afee-4408-a29b-48812154bc0c","name":"Criminal Division"},{"uuid":"a618801c-2b1e-4ce0-b47e-4db0bce55ac2","name":"Criminal - Criminal White Collar and Corporate Enforcement"},{"uuid":"4f03e6af-f2cb-40c6-89c8-6871fdd8aa47","name":"Drug Enforcement Administration (DEA)"},{"uuid":"dca09ceb-4978-4466-9c30-ce9f5ada2f0a","name":"Federal Bureau of Investigation (FBI)"},{"uuid":"544d3323-77d6-4482-917e-ff6c9b4a2fae","name":"USAO - Florida, Middle"},{"uuid":"7134133d-a27a-4c2c-8c45-cdc1da8e9c1a","name":"USAO - Florida, Southern"},{"uuid":"e14d3a2a-8182-4984-aed0-95e811946fc8","name":"USAO - Georgia, Southern"},{"uuid":"82adcbda-83a7-4aee-8a37-9f205426bb18","name":"USAO - Idaho"},{"uuid":"e36a034d-ac63-47b2-ad74-f2305b1942fb","name":"USAO - Kentucky, Western"},{"uuid":"8c990021-9ac2-41d5-b152-d00cd767abd9","name":"USAO - Louisiana, Eastern"},{"uuid":"efa9b0a3-60ef-43a1-9868-7817639284bd","name":"USAO - Louisiana, Middle"},{"uuid":"b1284e54-1a64-49f4-82c3-b02081ffee19","name":"USAO - New Jersey"},{"uuid":"552e5cc8-8b6c-48ac-894a-01aa6309f287","name":"USAO - New York, Eastern"},{"uuid":"06593b3a-b39b-41d5-b602-b4ef5ec4339c","name":"USAO - Ohio, Southern"},{"uuid":"e21ed86f-8c15-410a-9875-2ffeda1475cc","name":"USAO - South Carolina"},{"uuid":"9df3ecc7-70b1-4129-a052-089bce8b2ba2","name":"USAO - Texas, Southern"},{"uuid":"68248c1d-1d3d-4ed1-90c4-bea03bd5a1ca","name":"USAO - Washington, Eastern"},{"uuid":"1de80d15-6e2a-4303-9279-60533c6e1fc3","name":"USAO - Wisconsin, Eastern"}],"created":"\u003Ctime datetime=\u00222023-06-28T11:37:35-04:00\u0022\u003E1687966655\u003C\/time\u003E\n","date":"1687953600","image":"","number":"23-709","teaser":"\u003Cp\u003EThe Justice Department, together with federal and state law enforcement partners, announced today a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 78 defendants for their alleged participation in health care fraud and opioid abuse schemes that included over $2.5 billion in alleged fraud.\u003C\/p\u003E","title":"National Enforcement Action Results in 78 Individuals Charged for $2.5B in Health Care Fraud","topic":[{"uuid":"51b9125c-0741-4d24-a339-41f553c87538","name":"Opioids"},{"uuid":"d13d6b86-209f-460e-878e-b4dd44f9435f","name":"Prescription Drugs"},{"uuid":"77a2d846-a826-49db-a31a-c5db747e9ad3","name":"Financial Fraud"},{"uuid":"cce5d791-6b0b-462d-9a42-768179164d43","name":"Healthcare Fraud"}],"url":"https:\/\/www.justice.gov\/archives\/opa\/pr\/national-enforcement-action-results-78-individuals-charged-25b-health-care-fraud","uuid":"1a7015f1-8ff0-4375-95c6-6f63073a2dbb"},{"attachment":"","body":"\u003Cp\u003E\u003Cb\u003ENEW ORLEANS\u003C\/b\u003E \u2013 U.S. Attorney Duane A. Evans, the Department of Justice, together with federal and state law enforcement partners, today announced a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 78 defendants for their alleged participation in health care fraud and opioid abuse schemes that included over $2.5 billion in alleged fraud.\u003C\/p\u003E\n\n\u003Cp\u003EThe defendants allegedly defrauded programs entrusted for the care of the elderly and disabled, and, in some cases, used the proceeds of the schemes to purchase luxury items, including exotic automobiles, jewelry, and yachts. In connection with the enforcement action, the Department seized or restrained millions of dollars in cash, automobiles, and real estate.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThese enforcement actions, including against one of the largest health care fraud schemes ever prosecuted by the Justice Department, represent our intensified efforts to combat fraud and prosecute the individuals who profit from it,\u201d said Attorney General Merrick B. Garland. \u201cThe Justice Department will find and bring to justice criminals who seek to defraud Americans and steal from taxpayer-funded programs.\u201d\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThis nationwide enforcement action demonstrates that the Criminal Division is committed to fighting health care fraud and opioid abuse by prosecuting those who allegedly exploit patients and health care benefit programs for personal gain,\u201d said Assistant Attorney General Kenneth A. Polite, Jr. of the Justice Department\u2019s Criminal Division. \u201cToday\u2019s announcement includes some of the largest and most complex cases that the Department has prosecuted, and demonstrates the Department\u2019s commitment to seeking justice for those at all levels of the healthcare industry who put profits above patient care, from professionals in doctors\u2019 offices to executives in corporate boardrooms.\u201d\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u201cHealth care fraud is a complex and ever-evolving threat that negatively impacts the American people,\u201d said Assistant Director Luis Quesada of the FBI\u2019s Criminal Investigative Division. \u201cToday\u2019s nationwide coordinated law enforcement action is a testament to the tenacity of the FBI and our partners, as well as our combined efforts to pursue anyone who conspires to exploit our health care system for financial gain.\u201d\u003C\/p\u003E\n\n\u003Cp\u003EIn the Eastern District of Louisiana, Craig Lovelace, the owner and President of Advanced Medical Equipment Inc. (AME), a corporation doing business in Kenner, Louisiana, was charged on June 15, 2023 \u0026nbsp;by bill of information with Health Care Fraud.\u0026nbsp; AME operated as a durable medical equipment (DME) supply company that submitted claims to Medicare and Medicaid for DME supplied to beneficiaries. From approximately January 2016, and continuing through approximately 2022, Lovelace, through AME, allegedly executed a scheme to defraud Medicare and Medicaid by submitting, false and fraudulent claims for certain health care items purportedly supplied to beneficiaries. Such items, including DME, were alleged to be medically unnecessary, ineligible for Medicare reimbursement, or not provided as represented. Lovelace, in turn, used the fraudulent proceeds generated from this scheme for the benefit of himself and others.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cu\u003ETelemedicine Fraud \u003C\/u\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe enforcement action included charges against 11 defendants in connection with the submission of over $2 billion in fraudulent claims resulting from telemedicine schemes. In a case involving the alleged organizers of one of the largest health care fraud schemes ever prosecuted, an indictment in the Southern District of Florida alleges that the chief executive officer (CEO), former CEO, and Vice President of Business Development of purported software and services companies conspired to generate and sell templated doctors\u2019 orders for orthotic braces and pain creams in exchange for kickbacks and bribes. The conspiracy allegedly resulted in the submission of $1.9 billion in false and fraudulent claims to Medicare and other government insurers for orthotic braces, prescription skin creams, and other items that were medically unnecessary and ineligible for Medicare reimbursement.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EAs part of the alleged conspiracy, individuals in a massive telemarketing operation, located in the United States and abroad, targeted the elderly and disabled with direct mail, television advertisements, and other forms of advertising to induce them to contact offshore boiler-rooms staffed by individuals who \u201cup-sold\u201d the elderly and disabled on unnecessary medical equipment and prescriptions. According to the indictment, the software platform that the defendants allegedly operated was actually a conduit for these telemarketers to coordinate the payment of illegal kickbacks and bribes to telemedicine companies to obtain doctors\u2019 orders for Medicare beneficiaries. The defendants allegedly programmed the software platform to generate false and fraudulent orders for telemedicine practitioners to sign and obstruct Medicare investigations by concealing that the interactions with beneficiaries had occurred remotely using telemedicine. The program-generated orders falsified certifications that the telemedicine doctors had examined the beneficiaries in person, and falsified diagnostic testing that Medicare required for brace orders.\u0026nbsp;After the original CEO sold the company in a corporate acquisition, the new corporate leadership allegedly chose to continue the pre-existing fraud scheme.\u003C\/p\u003E\n\n\u003Cp\u003EIn another telemedicine fraud case, in the Eastern District of Washington, a licensed physician was charged for signing more than 2800 fraudulent orders for orthotic braces, including for patients whose limbs had already been amputated. As alleged, the physician took less than 40 seconds to review and sign each order.\u003C\/p\u003E\n\n\u003Cp\u003EThe cases announced today build on earlier telemedicine enforcement actions involving over $10.1 billion in fraud. The April 2019 Operation Brace Yourself Telemedicine and Durable Medical Equipment Takedown alone resulted in an estimated cost avoidance of more than $1.9 billion in the amount Medicare paid for orthotic braces in the 20 months following that enforcement action, preserving the Medicare trust fund for necessary medical care.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cPatients trust federal health care programs to provide high quality care. When bad actors steal from these programs, they hurt patients,\u201d said Inspector General Christi A. Grimm of the Department of Health and Human Services Office of the Inspector General (HHS-OIG). \u201cHHS-OIG is dedicated to protecting federal health care programs and putting patients first. Thank you to our law enforcement partners, especially the Medicaid Fraud Control Units, that participated in this effort.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cu\u003EPharmaceutical Fraud\u003C\/u\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe enforcement action also included charges against 10 defendants in connection with the submission of over $370 million in fraudulent claims submitted in connection with prescription drugs. In one case announced today, the owner and corporate officer of a pharmaceutical wholesale distribution company was charged for an alleged $150 million fraud scheme in which the company purchased illegally diverted prescription HIV medication, and then marketed and resold the medication by falsely representing that the company acquired it through legitimate channels. The defendant allegedly purchased the diverted medication at a substantial discount from individuals who obtained the drugs primarily through illegal \u201cbuyback\u201d schemes in which they paid HIV patients cash for their expensive HIV medication and repackaged those pills for resale. To cover up their scheme, the defendant and others falsified labeling and product tracing documentation to make it appear legitimate. Pharmacies purchased the misbranded medications, dispensed them to patients, and billed them to health care benefit programs, all while the defendants reaped substantial illegal profits.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EIn a related case, on June 15, an individual in the Southern District of Florida was sentenced to 15 years in prison for his role in this nationwide scheme. According to court documents, the defendant illegally acquired large quantities of prescription drugs from patients for whom the drugs had been prescribed but not yet consumed. The defendant and others then repackaged the drugs and sold them to wholesale companies. In some instances, the medication that the defendant sold contained the wrong medication, broken pills, and even pebbles, leading to complaints by pharmacies. The defendant used his share of the proceeds to purchase luxury goods, including a $280,000 Lamborghini, a $220,000 Mercedes, and three boats.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cu\u003EOpioid Distribution and Other Types of Health Care Fraud\u003C\/u\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe charges also targeted over $150 million in false billings submitted in connection with other types of health care fraud, including the illegal distribution of opioids and clinical laboratory testing fraud. Today\u2019s enforcement action includes charges against 24 physicians and other licensed medical professionals who lined their own pockets, including doctors who allegedly put their patients at risk by illegally providing them with opioids they did not need. The charges also include cases where healthcare companies, physicians, and other providers paid cash kickbacks to patient recruiters and beneficiaries in return for patient information, so that the providers could submit fraudulent bills for Medicare reimbursement.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u201cAt DEA, we are committed to protecting the safety and health of all Americans,\u201d said DEA Administrator Anne Milgram. \u201cWhen individuals divert addictive opioid medications for personal gain, they are knowingly putting Americans at risk, all too often causing harm and even death. DEA is committed to taking decisive action to hold accountable anyone who participates in these dangerous schemes.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cCHAMPVA provides community health care to family members of our nation\u2019s disabled or deceased veterans, and the defendants\u2019 alleged criminal actions resulted in a multibillion-dollar fraud scheme that puts those benefits at risk and pilfers significant taxpayer funds,\u201d said Inspector General Michael J. Missal of the Department of Veterans Affairs Office of Inspector General (VA-OIG). \u201cThe VA-OIG\u2019s continued oversight of VA\u2019s multiple healthcare programs, including CHAMPVA, is one of the agency\u2019s highest priorities. We thank our outstanding law enforcement partners for their efforts in this investigation.\u201d\u003C\/p\u003E\n\n\u003Cp\u003EThe Center for Program Integrity of the Centers for Medicare \u0026amp; Medicaid Services (CPI\/CMS) separately announced today that it took adverse administrative actions in the last six months against 90 medical providers for their alleged involvement in health care fraud.\u003C\/p\u003E\n\n\u003Cp\u003EPrincipal Assistant Deputy Chief Jacob Foster and Acting Assistant Chief Rebecca Yuan of the National Rapid Response Strike Force of the Criminal Division\u2019s Fraud Section led and coordinated today\u2019s enforcement action. The Health Care Fraud Unit\u2019s Strike Forces in Brooklyn, Dallas, Detroit, the Gulf Coast, Houston, Los Angeles, Miami, Newark, and Tampa; the Health Care Fraud Unit\u2019s National Rapid Response Strike Force; the U.S. Attorneys\u2019 Offices for the Middle District of Florida, Southern District of Florida, Southern District of Georgia, District of Idaho, Western District of Kentucky, Eastern District of Louisiana, Middle District of Louisiana, District of New Jersey, Eastern District of New York, Southern District of Ohio, District of South Carolina, Southern District of Texas, Eastern District of Washington, and Eastern District of Wisconsin; and the State Attorney Generals\u2019 Offices for Indiana, New York, and Pennsylvania are prosecuting these cases, with assistance from the Health Care Fraud Unit\u2019s Data Analytics Team. Descriptions of cases involved in today\u2019s enforcement action are available on the Department\u2019s website at \u003Ca href=\u0022https:\/\/www.justice.gov\/criminal-fraud\/health-care-fraud-unit\/2023-national-hcf-court-documents\u0022\u003Ewww.justice.gov\/criminal-fraud\/health-care-fraud-unit\/2023-national-hcf-court-documents\u003C\/a\u003E.\u003C\/p\u003E\n\n\u003Cp\u003EIn addition to the FBI, HHS-OIG, DEA, and CMS\/CPI, State Medicaid Fraud Control Units, HSI, FDA, IRS-CI, VA-OIG, USPS-OIG, FDIC-OIG, OPM-OIG, Amtrak-OIG, and other federal and state law enforcement agencies participated in the operation.\u003C\/p\u003E\n\n\u003Cp\u003EThe Fraud Section leads the Criminal Division\u2019s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, comprised of 15 strike forces operating in 25 federal districts, has charged more than 5,000 defendants who collectively have billed federal health care programs and private insurers more than $24 billion. More information can be found at \u003Ca href=\u0022https:\/\/www.justice.gov\/criminal-fraud\/health-care-fraud-unit\u0022\u003Ewww.justice.gov\/criminal-fraud\/health-care-fraud-unit\u003C\/a\u003E.\u003C\/p\u003E\n\n\u003Cp\u003EThe Fraud Section uses the Victim Notification System to provide victims with case information and updates related to this case. Victims with questions may contact the Fraud Section\u2019s Victim Assistance Unit by calling the Victim Assistance phone line at 1-888-549-3945 or by emailing \u003Ca href=\u0022mailto:victimassistance.fraud@usdoj.gov\u0022\u003Evictimassistance.fraud@usdoj.gov\u003C\/a\u003E. To learn more about victims\u2019 rights, please visit \u003Ca href=\u0022http:\/\/www.justice.gov\/criminal-vns\/victim-rights-derechos-de-las-v-ctimas\u0022\u003Ewww.justice.gov\/criminal-vns\/victim-rights-derechos-de-las-v-ctimas\u003C\/a\u003E, and for further information for victims about new federal charges in connection with the HIV scheme, please visit \u003Ca href=\u0022http:\/\/www.justice.gov\/criminal-vns\/case\/united-states-v-steven-diamantstein\u0022\u003Ewww.justice.gov\/criminal-vns\/case\/united-states-v-steven-diamantstein\u003C\/a\u003E.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Ci\u003EA complaint, information, or indictment is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.\u003C\/i\u003E\u003C\/p\u003E","changed":"\u003Ctime datetime=\u00222023-06-28T19:49:59-04:00\u0022\u003E1687996199\u003C\/time\u003E\n","component":[{"uuid":"e99b9547-7d65-42c6-9404-68fab0db9543","name":"Office of the Attorney General"},{"uuid":"46370d9f-afee-4408-a29b-48812154bc0c","name":"Criminal Division"},{"uuid":"a618801c-2b1e-4ce0-b47e-4db0bce55ac2","name":"Criminal - Criminal White Collar and Corporate Enforcement"},{"uuid":"4f03e6af-f2cb-40c6-89c8-6871fdd8aa47","name":"Drug Enforcement Administration (DEA)"},{"uuid":"dca09ceb-4978-4466-9c30-ce9f5ada2f0a","name":"Federal Bureau of Investigation (FBI)"},{"uuid":"8c990021-9ac2-41d5-b152-d00cd767abd9","name":"USAO - Louisiana, Eastern"}],"created":"\u003Ctime datetime=\u00222023-06-28T19:31:19-04:00\u0022\u003E1687995079\u003C\/time\u003E\n","date":"1687953600","image":"","number":"","teaser":"\u003Cp\u003E\u003Cb\u003ENEW ORLEANS\u003C\/b\u003E \u2013 U.S. Attorney Duane A. Evans, the Department of Justice, together with federal and state law enforcement partners, today announced a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 78 defendants for their alleged participation in health care fraud and opioid abuse schemes that included over $2.5 billion in alleged fraud.\u003C\/p\u003E","title":"National Enforcement Action Results in 78 Individuals Charged for $2.5B in Health Care Fraud","topic":[{"uuid":"51b9125c-0741-4d24-a339-41f553c87538","name":"Opioids"},{"uuid":"d13d6b86-209f-460e-878e-b4dd44f9435f","name":"Prescription Drugs"},{"uuid":"77a2d846-a826-49db-a31a-c5db747e9ad3","name":"Financial Fraud"},{"uuid":"cce5d791-6b0b-462d-9a42-768179164d43","name":"Healthcare Fraud"}],"url":"https:\/\/www.justice.gov\/usao-edla\/pr\/national-enforcement-action-results-78-individuals-charged-25b-health-care-fraud","uuid":"1468808a-e26c-4c4a-945f-73891f813bd1"},{"attachment":"","body":"\u003Cp\u003ECHARLESTON, W.Va. \u2013 United States Attorney Will Thompson announced criminal charges today against a Logan County physician and a Kentucky registered nurse in connection with separate alleged controlled substance abuse schemes. The charges filed in federal court are part of the Justice Department\u2019s 2024 National Health Care Fraud Enforcement Action.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cIt 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,\u201d said Attorney General Merrick B. Garland. \u201cThe Justice Department will bring to justice criminals who defraud Americans, steal from taxpayer-funded programs, and put people in danger for the sake of profits.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThe indictments handed up in the Southern District of West Virginia allege that the defendants betrayed their duties as health care providers for personal gain,\u201d Thompson said. \u201cThe nationwide enforcement action announced today shows the commitment of the U.S. Department of Justice and this office to safeguard patients and the health care system from abuse and fraud.\u201d\u003C\/p\u003E\n\n\u003Cp\u003EThe charges announced today by Thompson are part of a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 193 defendants for their alleged participation in health care fraud and controlled substance abuse schemes that resulted in the submission of over $2.75 billion in alleged false billings. The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets, and the Government, in connection with the enforcement action, seized over $231 million in cash, luxury vehicles, gold, and other assets.\u003C\/p\u003E\n\n\u003Cp\u003EThe Health Care Fraud Unit\u2019s National Rapid Response, Florida, Gulf Coast, Los Angeles, Midwest, Northeast, and Texas Strike Forces; U.S. Attorneys\u2019 Offices for the Southern District of Alabama, District of Arizona, Central District of California, Northern District of California, Southern District of California, District of Connecticut, Middle District of Florida, Southern District of Florida, Northern District of Illinois, Eastern District of Kentucky, Western District to Kentucky, Eastern District of Louisiana, Middle District of Louisiana, Western District of Louisiana, Eastern District of Michigan, Western District of Michigan, Southern District of Mississippi, District of Montana, District of New Jersey, Eastern District of New York, Eastern District of North Carolina, Western District of Oklahoma, District of Rhode Island, Eastern District of Tennessee, Middle District of Tennessee, Eastern District of Texas, Northern District of Texas, Southern District of Texas, Eastern District of Virginia, Western District of Virginia, Southern District of West Virginia, and Eastern District of Wisconsin; and State Attorney Generals\u2019 Offices for Arizona, California, Illinois, Indiana, Louisiana, New York, Oklahoma, Pennsylvania, Puerto Rico, Rhode Island, and South Dakota are prosecuting the cases in the National Enforcement Action, with assistance from the Health Care Fraud Unit\u2019s Data Analytics Team.\u003C\/p\u003E\n\n\u003Cp\u003EDescriptions of each case involved in today\u2019s enforcement action are available \u003Ca href=\u0022http:\/\/www.justice.gov\/criminal\/criminal-fraud\/health-care-fraud-unit\/2024-national-hcf-case-summaries\u0022\u003Eon the Department\u2019s website\u003C\/a\u003E.\u003C\/p\u003E\n\n\u003Cp\u003EThe Southern District of West Virginia, in particular, worked with the Department\u2019s Criminal Division and the following law enforcement organizations to investigate and prosecute the cases filed during the enforcement period: the Drug Enforcement Administration (DEA) and the Food and Drug Administration-Office of Criminal Investigations (FDA-OCI).\u003C\/p\u003E\n\n\u003Cp\u003EThe following individuals have been charged in the Southern District of West Virginia:\u003C\/p\u003E\n\n\u003Cul\u003E\n\u003Cli\u003EBrian McDevitt, D.O., 60, of Chapmanville, was charged by indictment with three counts of unlawful distribution of a controlled substance in connection with prescribing clonazepam outside the scope of professional practice and not for a legitimate medical purpose. As alleged in the indictment, McDevitt, a sole practitioner operating the Chapmanville Medical Clinic, knowingly issued clonazepam prescriptions on three separate dates that were outside the scope of professional practice and not for a legitimate medical purpose. The case is being prosecuted by Assistant United States Attorneys Owen Reynolds and Francesca Rollo.\u003C\/li\u003E\n\u003C\/ul\u003E\n\n\u003Cul\u003E\n\u003Cli\u003EJacqueline Brewster, 54, of Belfry, Kentucky, was charged by indictment with one count of obtaining controlled substances by fraud, one count of tampering with consumer products, and one count of wrongfully obtaining individually identifiable health information under false pretenses and with intent to use for personal gain in connection with the theft of, and tampering with, vials of hydromorphone at a hospital in Raleigh County, West Virginia. As alleged in the indictment, Brewster, a travel nurse, used her credentials to access hydromorphone for her own personal use. Brewster tampered with the hydromorphone vials by diluting the remaining liquid in the bottles to make it appear as though they were full. As part of this scheme, Brewster accessed patient files for patients not assigned to her. The case is being prosecuted by Assistant United States Attorney Owen Reynolds.\u003C\/li\u003E\n\u003C\/ul\u003E\n\n\u003Cp\u003E\u003Ci\u003EA complaint, information, or indictment is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.\u003C\/i\u003E\u003C\/p\u003E\n\n\u003Cp\u003EA copy of this press release is located on the website of the \u003Ca href=\u0022https:\/\/www.justice.gov\/usao\/wvs\u0022\u003EU.S. Attorney\u2019s Office\u003C\/a\u003E for the Southern District of West Virginia. Related court documents and information can be found on\u0026nbsp;\u003Ca href=\u0022https:\/\/pacer.login.uscourts.gov\/csologin\/login.jsf?pscCourtId=WVSDC\u0026amp;appurl=https:\/\/ecf.wvsd.uscourts.gov\/cgi-bin\/showpage.pl?16\u0022\u003EPACER\u003C\/a\u003E\u0026nbsp;by searching for Case Nos. 2:24-cr-96 McDevitt) and 5:24-cr-104 (Brewster).\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003E\u0026nbsp;\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cb\u003E###\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003E\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u0026nbsp;\u003C\/p\u003E","changed":"\u003Ctime datetime=\u00222024-06-27T15:18:49-04:00\u0022\u003E1719515929\u003C\/time\u003E\n","component":[{"uuid":"6decd6a7-23cb-4fef-b50c-791f6604191f","name":"USAO - West Virginia, Southern"}],"created":"\u003Ctime datetime=\u00222024-06-27T11:51:28-04:00\u0022\u003E1719503488\u003C\/time\u003E\n","date":"1719489600","image":"","number":"","teaser":"","title":"National Enforcement Action Results in 193 Individuals Charged, Including 2 in West Virginia, for Over $2.75 Billion in False Claims and Controlled Substance Abuse Schemes","topic":[{"uuid":"51b9125c-0741-4d24-a339-41f553c87538","name":"Opioids"},{"uuid":"d13d6b86-209f-460e-878e-b4dd44f9435f","name":"Prescription Drugs"},{"uuid":"cce5d791-6b0b-462d-9a42-768179164d43","name":"Healthcare Fraud"}],"url":"https:\/\/www.justice.gov\/usao-sdwv\/pr\/national-enforcement-action-results-193-individuals-charged-including-2-west-virginia","uuid":"2f8228e7-10cf-4b33-9697-5444113a6bd1"},{"attachment":"","body":"\u003Cp\u003EKNOXVILLE, Tenn. \u2013 Today, U.S. Attorney Francis M. Hamilton III announced criminal charges against six defendants in connection with alleged schemes to defraud the U.S. Department of Labor, Office of Worker\u2019s Compensation Program, Division of Energy Employees Occupational Illness Compensation (\u201cDOL-DEEOIC\u201d). \u0026nbsp;The charges filed in federal court are part of the Justice Department\u2019s 2024 National Health Care Fraud Enforcement Action. \u0026nbsp;The charges stem from the submission, or causing the submission, of fraudulent claims for home health services that were not actually rendered.\u003C\/p\u003E\n\n\u003Cp\u003EThe charges announced today by U.S. Attorney Hamilton are part of a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 193 defendants for their alleged participation in health care fraud and opioid abuse schemes that, in the aggregate, resulted in the submission of over $2.75 billion in alleged false billings.\u003C\/p\u003E\n\n\u003Cp\u003EThe DOJ Health Care Fraud Unit\u2019s National Rapid Response, Florida, Gulf Coast, Los Angeles, Midwest, Northeast, and Texas Strike Forces; U.S. Attorneys\u2019 Offices for the Southern District of Alabama, District of Arizona, Central District of California, Northern District of California, Southern District of California, District of Connecticut, Middle District of Florida, Southern District of Florida, Northern District of Illinois, Eastern District of Kentucky, Western District to Kentucky, Eastern District of Louisiana, Middle District of Louisiana, Western District of Louisiana, Eastern District of Michigan, Western District of Michigan, Southern District of Mississippi, District of Montana, District of New Jersey, Eastern District of New York, Eastern District of North Carolina, Western District of Oklahoma, District of Rhode Island, Eastern District of Tennessee, Middle District of Tennessee, Eastern District of Texas, Northern District of Texas, Southern District of Texas, Eastern District of Virginia, Western District of Virginia, Southern District of West Virginia, and Eastern District of Wisconsin; and State Attorney Generals\u2019 Offices for Arizona, California, Illinois, Indiana, Louisiana, New York, Oklahoma, Pennsylvania, Puerto Rico, Rhode Island, and South Dakota are prosecuting the cases in the National Enforcement Action, with assistance from the Health Care Fraud Unit\u2019s Data Analytics Team. \u0026nbsp;Descriptions of each case involved in today\u2019s enforcement action are available on the Department\u2019s website at \u003Ca href=\u0022http:\/\/www.justice.gov\/criminal\/criminal-fraud\/health-care-fraud-unit\/2024-national-hcf-case-summaries\u0022\u003ECase Descriptions\u003C\/a\u003E.\u003C\/p\u003E\n\n\u003Cp\u003EThe U.S. Attorney\u2019s Office for the Eastern District of Tennessee, in particular, worked with the Federal Bureau of Investigation, the Department of Labor \u2013 Office of Inspector General, and the Tennessee Medicaid Fraud Control Unit.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EIn the United States District Court for the Eastern District of Tennessee, Caleb Mullins, 40, Megan Mullins, 37, both of Oak Ridge, Tennessee, and CAMM Care, LLC doing business as Patriot Homecare (\u201cCAMM Care\u201d), were charged by indictment in connection with an alleged scheme to defraud the DOL-DEEOIC.\u0026nbsp; DOL-DEEOIC administers the health care benefit program designed to compensate current or former Department of Energy employees, vendors, contractors, and subcontractors diagnosed with occupational illnesses causally linked to toxic exposures during their employment.\u0026nbsp; Among other health care benefits, this program provides home health benefits to qualifying beneficiaries, including skilled nursing care and non-skilled care.\u0026nbsp; As alleged in the indictment, Caleb Mullins, the owner and President of CAMM Care, and Megan Mullins, the Executive Vice President of CAMM Care, conspired with each other and others not named in the indictment to create and submit fraudulent payment claims for homecare services that were not actually rendered.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003ESamantha Seiber (\u201cSeiber\u201d), 35, of Wartburg, Tennessee, Apryl Hard (\u201cHard\u201d), 46, of Louisville, Tennessee, and Lois Hamby (\u201cHamby\u201d), 62, of Oliver Springs, Tennessee, were also charged in separate indictments with defrauding the DOL-DEEOIC.\u0026nbsp; As alleged in the respective indictments, Seiber, Hard, and Hamby each had her own DOL-DEEOIC provider number, and each billed the DOL-DEEOIC for skilled nursing services that were not actually rendered.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EThe cases in the Eastern District of Tennessee are being prosecuted by Assistant United States Attorneys William A. Roach, Jr., and Jeremy S. Dykes of the United States Attorney\u2019s Office for the Eastern District of Tennessee.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Ci\u003EA complaint, information, or indictment is merely an allegation. \u0026nbsp;All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.\u003C\/i\u003E\u003C\/p\u003E\n\n\u003Cp\u003E\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; ###\u003C\/p\u003E","changed":"\u003Ctime datetime=\u00222024-06-27T18:10:39-04:00\u0022\u003E1719526239\u003C\/time\u003E\n","component":[{"uuid":"4f03e6af-f2cb-40c6-89c8-6871fdd8aa47","name":"Drug Enforcement Administration (DEA)"},{"uuid":"9caf0e5b-d69e-49a3-8223-cb8d28ed7e89","name":"Criminal Investigative Division (FBI)"},{"uuid":"3601535d-4e8a-4029-a9aa-12d40fdbfa41","name":"USAO - Tennessee, Eastern"}],"created":"\u003Ctime datetime=\u00222024-06-27T13:44:12-04:00\u0022\u003E1719510252\u003C\/time\u003E\n","date":"1719489600","image":"","number":"","teaser":"","title":"National Health Care Fraud Enforcement Action Results In 193 Defendants Charged And Over $2.75 Billion In False Claims","topic":[{"uuid":"cce5d791-6b0b-462d-9a42-768179164d43","name":"Healthcare Fraud"}],"url":"https:\/\/www.justice.gov\/usao-edtn\/pr\/national-health-care-fraud-enforcement-action-results-193-defendants-charged-and-over","uuid":"9667f11d-0929-48f5-8739-02bb0d3b75ad"},{"attachment":"","body":"\u003Cp\u003EThe Justice Department today announced the 2024 National Health Care Fraud Enforcement Action, which resulted in criminal charges against 193 defendants, including 76 doctors, nurse practitioners, and other licensed medical professionals in 32 federal districts across the United States, for their alleged participation in various health care fraud schemes involving approximately $2.75 billion in intended losses and $1.6 billion in actual losses.\u003C\/p\u003E\n\n\u003Cp\u003EIn connection with the coordinated nationwide law enforcement action, and together with federal and state law enforcement partners, the government seized over $231 million in cash, luxury vehicles, gold, and other assets.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cIt 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,\u201d said Attorney General Merrick B. Garland. \u201cThe Justice Department will bring to justice criminals who defraud Americans, steal from taxpayer-funded programs, and put people in danger for the sake of profits.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThe extraordinary Special Agents of Homeland Security Investigations (HSI) were proud to play an integral role in this multi-agency investigation and national takedown of healthcare fraud,\u201d said Secretary of Homeland Security Alejandro N. Mayorkas. \u201cThrough this action, we in federal law enforcement send a clear and strong message\u2014that we will hold accountable those health care providers and prescribers who prey on their patients for profit and disregard the first rule of medical care: do no harm.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cHealthcare fraud victimizes patients, endangers the health of vulnerable people, and plunders healthcare programs,\u201d said FBI Director Christopher Wray. \u201cThis wide-ranging collaboration demonstrates the FBI\u2019s commitment to rooting out predatory healthcare fraud, protecting patients, and ensuring critical healthcare funds go where they are needed most.\u201d\u003C\/p\u003E\n\n\u003Cp\u003EThe charges alleged include over $900 million fraud scheme committed in connection with amniotic wound grafts; the unlawful distribution of millions of pills of Adderall and other stimulants by five defendants associated with a digital technology company; an over $90 million fraud committed by corporate executives distributing adulterated and misbranded HIV medication; over $146 million in fraudulent addiction treatment schemes; over $1.1 billion in telemedicine and laboratory fraud; and over $450 million in other health care fraud and opioid schemes. \u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u201cHealth care fraud affects every American,\u201d said Principal Deputy Assistant Attorney General Nicole M. Argentieri, head of the Justice Department\u2019s Criminal Division. \u201cIt siphons off hard-earned tax dollars meant to provide care for the vulnerable and disabled. In doing so, it also raises the cost of care for all patients. Even worse, as the prosecutions we announce today underscore, health care fraud can harm patients and fuel addiction. The Criminal Division is committed to rooting out health care fraud, wherever it may be found, no matter who commits it.\u0026nbsp; And we are using more tools than ever before to uncover misconduct and hold wrongdoers to account, whether they are executives in corner offices or doctors who violate their oaths.\u201d\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EToday\u2019s enforcement action was led and coordinated by the Health Care Fraud Unit of the Criminal Division\u2019s Fraud Section and its core partners: U.S. Attorneys\u2019 Offices, the Department of Health and Human Services Office of Inspector General (HHS-OIG), FBI, and Drug Enforcement Administration (DEA). The cases were investigated by agents from the division\u2019s core partner agencies along with other federal and state law enforcement agencies. The cases are being prosecuted by Health Care Fraud Strike Force teams from the Criminal Division\u2019s Fraud Section, 32 U.S. Attorneys\u2019 Offices nationwide, and 11 State Attorney Generals\u2019 Offices.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThis work is important to the Department of Health and Human Services (HHS) and the millions of Americans we serve. HHS vigorously pursues anyone who commits fraud against our health care programs. But it takes all of us, working together, to be successful,\u201d said HHS Deputy Secretary Andrea Palm. \u201cThose who steal from these programs are stealing from the American families who rely on them and putting patients at risk. We won\u2019t stop until all those who try to defraud the federal government are caught and held accountable.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cWe will not tolerate fraud that preys on patients who need and deserve high quality health care,\u201d said the HHS-OIG Inspector General Christi A. Grimm. \u201cThe hard work of the HHS-OIG team and our outstanding law enforcement partners makes today\u2019s action possible. We must protect taxpayer dollars and keep Americans safe from harms to their health, privacy, and financial well-being.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cu\u003EAmniotic Wound Grafts\u003C\/u\u003E\u003C\/p\u003E\n\n\u003Cp\u003ECharges were filed in the District of Arizona against four individuals who allegedly filed $900 million in false and fraudulent claims to Medicare for amniotic wound grafts used on Medicare patients. As alleged, the defendants targeted elderly Medicare patients, many of whom were terminally ill. The defendants caused medically unnecessary and expensive amniotic grafts to be applied to these vulnerable patients\u2019 wounds indiscriminately, without coordination with the patients\u2019 treating physicians and without proper treatment for infection, to superficial wounds that did not need this treatment, and in sizes that far exceeded the size of the wound. In just 16 months, Medicare paid two defendants more than $600 million as a result of their fraud scheme, paying on average more than a million dollars per patient for these unnecessary grafts. These two defendants owned wound care companies in Arizona and received more than $330 million in illegal kickbacks in exchange for purchasing the grafts billed to Medicare. In connection with the charges, the government seized over $70 million, including four luxury vehicles, gold, jewelry, and cash.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cEvery dollar saved by investigating fraud is critical to the sustainability of the Medicare program and the needs of the people who depend on it,\u201d said Administrator Chiquita Brooks-LaSure of the Centers for Medicare \u0026amp; Medicaid Services (CMS). \u201cIn addition to the actions taken by the Justice Department, CMS took 127 administrative actions in the last six months separately against providers for their alleged involvement in health care fraud schemes. We thank our partners at the Department of Justice and Department of Health and Human Services Office of Inspector General for working closely with us to identify, investigate, and eliminate waste, fraud, and abuse in our federal health care programs.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cu\u003EDistribution of Adderall and Other Stimulants\u003C\/u\u003E\u003C\/p\u003E\n\n\u003Cp\u003EFive additional defendants associated with digital technology company Done Global Inc. and its affiliated entity, Done Health P.C. (collectively, \u201cDone\u201d), were charged for the unlawful distribution of millions of Adderall pills. The CEO and Clinical President of Done \u003Ca href=\u0022https:\/\/www.justice.gov\/opa\/pr\/founderceo-and-clinical-president-digital-health-company-arrested-100m-adderall-distribution\u0022\u003Ewere charged on June 13\u003C\/a\u003E in a scheme to distribute Adderall and other stimulants over the internet. The charges announced today include those against one of the most prolific prescribers working for Done, a Florida nurse practitioner who prescribed over 1.5 million pills of Adderall and other stimulants to patients across the United States. The indictment alleges that the nurse practitioner prescribed Adderall and other stimulants without interaction with patients, pursuant to Done\u2019s \u201cauto-refill\u201d policy. This policy allowed patients to obtain continued prescriptions after an initial encounter without any further audio or visual interaction with a medical professional. This allegedly resulted in the nurse practitioner prescribing Adderall and other stimulants to individuals suffering from drug addiction and continuing to issue Adderall prescriptions for months after the overdose deaths of patients.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cDEA works tirelessly to protect the public from harm, be it cartels funneling fentanyl into our communities or medical providers caring more about profits than patients,\u201d said DEA Administrator Anne Milgram. \u201cThe CEO and clinical director of Done Global Inc. are charged with over-prescribing millions of unneeded stimulant pills, potentially putting patients in danger and exacerbating the current stimulant medicine shortage. The seriousness of these actions should not be understated. DEA will continue to hold anyone accountable who endangers the health and well-being of Americans.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cu\u003EDiverted HIV Medication\u003C\/u\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThree owners and executives of a wholesale distributor of pharmaceutical drugs were charged in connection with an alleged $90 million wire fraud conspiracy to introduce adulterated and misbranded HIV drugs into the market. The HIV drugs were allegedly acquired through unlawful \u201cbuyback\u201d schemes in which previously dispensed bottles of prescription drugs were bought from vulnerable patients. The defendants allegedly purchased these drugs from the black market and resold them to pharmacies throughout the country with falsified documentation designed to conceal the true source of the medication. Pharmacies then dispensed these diverted HIV medications to unsuspecting patients.\u0026nbsp;At times, patients received bottles labeled as their prescription medication, but the bottles contained a different drug entirely, with one patient passing out and remaining unconscious for 24 hours after taking an anti-psychotic drug thinking it was his prescribed HIV medication.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cu\u003EAddiction Treatment Cases\u003C\/u\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe addiction treatment cases announced today include charges filed in the District of Arizona and Southern District of Florida against four defendants in connection with more than $146 million of allegedly false and fraudulent claims for services for vulnerable patients seeking treatment for drug or alcohol addiction. As alleged in one of the indictments, one defendant paid kickbacks in exchange for the referral of patients recruited from the homeless population and Native American reservations. She then fraudulently billed Arizona Medicaid for substance abuse treatment services that were either never provided or were provided at a level that was so substandard that it failed to serve any treatment purpose. The defendant is charged with money laundering offenses for her lavish purchases with the fraud proceeds, as well as obstruction of justice for allegedly falsifying records in response to a grand jury subpoena for documents.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cu\u003ETelemedicine and Laboratory Fraud Cases\u003C\/u\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThirty-six defendants were charged in connection with the submission of over $1.1 billion in fraudulent claims to Medicare resulting from telemedicine schemes. For example, in separate cases involving similar schemes that were perpetrated by different criminal networks in the Southern District of Texas, Northern District of Texas, and District of New Jersey, clinical laboratory owners allegedly paid illegal kickbacks and bribes, including to telemedicine companies, in exchange for the referral of orders for unnecessary genetic testing. The results of these genetic tests\u2014which were supposed to detect genetic mutations that could indicate an elevated risk of cancer, cardiovascular disease, Parkinson\u2019s disease, and other serious illness\u2014were not used in the patients\u2019 treatment. Other telemedicine schemes included the unsealing of a complaint in the Eastern District of Virginia against a psychiatrist who allegedly submitted fraudulent claims based on minimal patient interactions, including for visits that lasted between 10 to 30 seconds. The continued focus on prosecuting health care fraud schemes involving telemedicine reflects the Department\u2019s commitment to rooting out these schemes, which has saved taxpayers \u003Ca href=\u0022https:\/\/www.justice.gov\/opa\/pr\/national-enforcement-action-results-78-individuals-charged-25b-health-care-fraud\u0022\u003Ebillions of dollars\u003C\/a\u003E.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cu\u003ECases Involving the Illegal Prescription and Distribution of Opioids and Other Health Care Fraud Schemes \u003C\/u\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe other cases announced today charge 14 defendants with crimes related to the illegal prescription and distribution of opioids that resulted in millions in false billings, including several charges against medical professionals and others who prescribed unnecessary opioids, Suboxone, and other controlled substances.\u003C\/p\u003E\n\n\u003Cp\u003EAn additional 126 defendants are charged with various other health care fraud schemes involving over $450 million in false and fraudulent claims to Medicare, Medicaid, and private insurance companies for treatments that were medically unnecessary or never provided. Ten defendants across the country were charged in connection with fraudulent COVID-19 testing, including an over $65 million scheme charged in the Southern District of Florida.\u003C\/p\u003E\n\n\u003Cp\u003EThe Center for Program Integrity of the Centers for Medicare and Medicaid Services (CPI\/CMS) separately announced today that it took adverse administrative actions in the last six months against 127 medical providers for their alleged involvement in health care fraud.\u003C\/p\u003E\n\n\u003Cp\u003EPrincipal Assistant Deputy Chief Jacob Foster, Assistant Chief Rebecca Yuan, and Trial Attorney Miriam L. Glaser Dauermann of the Health Care Fraud Unit of the Criminal Division\u2019s Fraud Section led and coordinated today\u2019s enforcement action. The cases are being prosecuted by the Health Care Fraud Unit\u2019s National Rapid Response, Florida, Gulf Coast, Los Angeles, Midwest, Northeast, and Texas Strike Forces; U.S. Attorneys\u2019 Offices for the Southern District of Alabama, District of Arizona, Central District of California, Northern District of California, Southern District of California, District of Connecticut, Middle District of Florida, Southern District of Florida, Northern District of Illinois, Eastern District of Kentucky, Western District of Kentucky, Eastern District of Louisiana, Middle District of Louisiana, Western District of Louisiana, Eastern District of Michigan, Western District of Michigan, Southern District of Mississippi, District of Montana, District of New Jersey, Eastern District of New York, Eastern District of North Carolina, Western District of Oklahoma, District of Rhode Island, Eastern District of Tennessee, Middle District of Tennessee, Eastern District of Texas, Northern District of Texas, Southern District of Texas, Eastern District of Virginia, Western District of Virginia, Southern District of West Virginia, and Eastern District of Wisconsin; and State Attorney Generals\u2019 Offices for Arizona, California, Illinois, Indiana, Louisiana, New York, Oklahoma, Pennsylvania, Puerto Rico, Rhode Island, and South Dakota. The Health Care Fraud Unit\u2019s Data Analytics Team used cutting-edge data analytics to identify and support the investigations that led to these charges.\u003C\/p\u003E\n\n\u003Cp\u003EIn addition to the FBI, HHS-OIG, DEA, and CMS\/CPI, HSI, IRS Criminal Investigation, Department of Veterans Affairs Office of Inspector General, Defense Criminal Investigative Service, Department of Labor, United States Postal Service Office of Inspector General, and other federal, state, and local law enforcement agencies participated in the operation. The Medicaid Fraud Control Units of the states of Arizona, California, Connecticut, Florida, Illinois, Indiana, Kentucky, Louisiana, New York, North Carolina, Oklahoma, Pennsylvania, Puerto Rico, Rhode Island, South Dakota, Tennessee, Texas, and Virginia also participated in the investigation of many of the federal and state cases announced today.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EThe Fraud Section leads the Criminal Division\u2019s efforts to combat health care fraud through the Health Care Fraud Strike Force. Prior to the charges announced as part of today\u2019s nationwide enforcement action and since its inception in March 2007, the Health Care Fraud Strike Force, which operates in 27 districts, charged more than 5,400 defendants who collectively billed Medicare, Medicaid, and private health insurers more than $27 billion.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cem\u003EAn indictment, information, or complaint is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.\u003C\/em\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe following documents related to today\u2019s announcement are available on the Health Care Fraud Unit website through these links:\u003C\/p\u003E\n\n\u003Cul\u003E\n\u003Cli\u003E\u003Ca href=\u0022http:\/\/www.justice.gov\/criminal\/criminal-fraud\/health-care-fraud-unit\/2024-national-health-care-fraud-enforcement-action\u0022\u003EGraphics and Resources\u003C\/a\u003E\u003C\/li\u003E\n\u003Cli\u003E\u003Ca href=\u0022http:\/\/www.justice.gov\/criminal\/criminal-fraud\/health-care-fraud-unit\/2024-national-hcf-case-summaries\u0022\u003ECase Descriptions\u003C\/a\u003E\u003C\/li\u003E\n\u003Cli\u003E\u003Ca href=\u0022https:\/\/www.justice.gov\/criminal\/criminal-fraud\/health-care-fraud-unit\/2024-national-hcf-court-documents\u0022\u003ECourt Documents\u003C\/a\u003E\u003C\/li\u003E\n\u003C\/ul\u003E","changed":"\u003Ctime datetime=\u00222025-02-06T14:33:05-05:00\u0022\u003E1738870385\u003C\/time\u003E\n","component":[{"uuid":"e99b9547-7d65-42c6-9404-68fab0db9543","name":"Office of the Attorney General"},{"uuid":"46370d9f-afee-4408-a29b-48812154bc0c","name":"Criminal Division"},{"uuid":"a618801c-2b1e-4ce0-b47e-4db0bce55ac2","name":"Criminal - Criminal White Collar and Corporate Enforcement"},{"uuid":"4f03e6af-f2cb-40c6-89c8-6871fdd8aa47","name":"Drug Enforcement Administration (DEA)"},{"uuid":"dca09ceb-4978-4466-9c30-ce9f5ada2f0a","name":"Federal Bureau of Investigation (FBI)"},{"uuid":"fcdb4086-657f-455b-ab90-78398e483bff","name":"USAO - Alabama, Southern"},{"uuid":"d139d6e1-c7f0-481e-8385-3a94932f1a53","name":"USAO - Arizona"},{"uuid":"ab636464-816a-4a67-967e-00eb15e40ff3","name":"USAO - California, Central"},{"uuid":"9562bf08-d474-4f10-a607-87ba645cee03","name":"USAO - California, Northern"},{"uuid":"fdad26ae-a50e-41f0-90c6-0e0f10c69b9c","name":"USAO - California, Southern"},{"uuid":"ff874cc1-ca76-4aa4-8013-d253aca40328","name":"USAO - Connecticut"},{"uuid":"544d3323-77d6-4482-917e-ff6c9b4a2fae","name":"USAO - Florida, Middle"},{"uuid":"7134133d-a27a-4c2c-8c45-cdc1da8e9c1a","name":"USAO - Florida, Southern"},{"uuid":"f157cfe4-d5d0-4d1a-89c7-48047a07005f","name":"USAO - Illinois, Northern"},{"uuid":"f4eaf2ff-2595-4bee-bcfd-90d9bd09435d","name":"USAO - Kentucky, Eastern"},{"uuid":"e36a034d-ac63-47b2-ad74-f2305b1942fb","name":"USAO - Kentucky, Western"},{"uuid":"8c990021-9ac2-41d5-b152-d00cd767abd9","name":"USAO - Louisiana, Eastern"},{"uuid":"efa9b0a3-60ef-43a1-9868-7817639284bd","name":"USAO - Louisiana, Middle"},{"uuid":"b7134f95-28b2-4b7e-95c9-a49fa5dfd6e2","name":"USAO - Louisiana, Western"},{"uuid":"b67ce1d4-10d6-4ea1-b582-444dec4e8c1e","name":"USAO - Michigan, Eastern"},{"uuid":"76fae1b5-b1ed-4f8b-a487-dd52025ba7da","name":"USAO - Michigan, Western"},{"uuid":"e0caf4e9-dfe7-461d-bba1-5423e45ec34f","name":"USAO - Mississippi, Southern"},{"uuid":"a0640475-6d76-4fcb-b891-c0de885bf3d3","name":"USAO - Montana"},{"uuid":"b1284e54-1a64-49f4-82c3-b02081ffee19","name":"USAO - New Jersey"},{"uuid":"552e5cc8-8b6c-48ac-894a-01aa6309f287","name":"USAO - New York, Eastern"},{"uuid":"d80e5ea7-90b3-4607-8495-a16ee5a2f772","name":"USAO - North Carolina, Eastern"},{"uuid":"d6be3941-8347-4608-805f-23c4b4fd7d28","name":"USAO - Oklahoma, Western"},{"uuid":"e17ec19f-b1c6-4c6d-a849-6de60c8a12ef","name":"USAO - Rhode Island"},{"uuid":"ae7c72ba-bf50-4359-9290-5b9c46908ba6","name":"USAO - Tennessee, Middle"},{"uuid":"7640bef5-117f-47d2-9226-572020e05213","name":"USAO - Texas, Eastern"},{"uuid":"8df05d6d-6610-4258-9c93-cf09539e3683","name":"USAO - Texas, Northern"},{"uuid":"9df3ecc7-70b1-4129-a052-089bce8b2ba2","name":"USAO - Texas, Southern"},{"uuid":"7e997054-52a5-485c-82a1-1a0e161abc4e","name":"USAO - Virginia, Eastern"},{"uuid":"42408f6b-4f4a-4762-b2b2-1130ea85b32f","name":"USAO - Virginia, Western"},{"uuid":"6decd6a7-23cb-4fef-b50c-791f6604191f","name":"USAO - West Virginia, Southern"},{"uuid":"1de80d15-6e2a-4303-9279-60533c6e1fc3","name":"USAO - Wisconsin, Eastern"}],"created":"\u003Ctime datetime=\u00222024-06-27T14:02:46-04:00\u0022\u003E1719511366\u003C\/time\u003E\n","date":"1719489600","image":"","number":"24-821","teaser":"","title":"National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 Billion in False Claims","topic":[{"uuid":"cce5d791-6b0b-462d-9a42-768179164d43","name":"Healthcare Fraud"}],"url":"https:\/\/www.justice.gov\/archives\/opa\/pr\/national-health-care-fraud-enforcement-action-results-193-defendants-charged-and-over-275-0","uuid":"1e4788bc-6e67-4b15-9d85-7e994b75346a"},{"attachment":"","body":"\u003Cp\u003ECHARLOTTESVILLE, Va. \u2013 The Justice Department today announced the 2024 National Health Care Fraud Enforcement Action, which resulted in criminal charges against 193 defendants, including 76 doctors, nurse practitioners, and other licensed medical professionals in 32 federal districts across the United States, for their alleged participation in various health care fraud schemes involving approximately $2.75 billion in intended losses and $1.6 billion in actual losses.\u003C\/p\u003E\n\n\u003Cp\u003EIn connection with the coordinated nationwide law enforcement action, and together with federal and state law enforcement partners, the government seized over $231 million in cash, luxury vehicles, gold, and other assets.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cIt 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,\u201d said Attorney General Merrick B. Garland. \u201cThe Justice Department will bring to justice criminals who defraud Americans, steal from taxpayer-funded programs, and put people in danger for the sake of profits.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThe extraordinary Special Agents of Homeland Security Investigations (HSI) were proud to play an integral role in this multi-agency investigation and national takedown of healthcare fraud,\u201d said Secretary of Homeland Security Alejandro N. Mayorkas. \u201cThrough this action, we in federal law enforcement send a clear and strong message\u2014that we will hold accountable those health care providers and prescribers who prey on their patients for profit and disregard the first rule of medical care: do no harm.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cHealthcare fraud victimizes patients, endangers the health of vulnerable people, and plunders healthcare programs,\u201d said FBI Director Christopher Wray. \u201cThis wide-ranging collaboration demonstrates the FBI\u2019s commitment to rooting out predatory healthcare fraud, protecting patients, and ensuring critical healthcare funds go where they are needed most.\u201d\u003C\/p\u003E\n\n\u003Cp\u003EThe charges alleged include over $900 million fraud scheme committed in connection with amniotic wound grafts; the unlawful distribution of millions of pills of Adderall and other stimulants by five defendants associated with a digital technology company; an over $90 million fraud committed by corporate executives distributing adulterated and misbranded HIV medication; over $146 million in fraudulent addiction treatment schemes; over $1.1 billion in telemedicine and laboratory fraud; and over $450 million in other health care fraud and opioid schemes. \u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u201cHealth care fraud affects every American,\u201d said Principal Deputy Assistant Attorney General Nicole M. Argentieri, head of the Justice Department\u2019s Criminal Division. \u201cIt siphons off hard-earned tax dollars meant to provide care for the vulnerable and disabled. In doing so, it also raises the cost of care for all patients. Even worse, as the prosecutions we announce today underscore, health care fraud can harm patients and fuel addiction. The Criminal Division is committed to rooting out health care fraud, wherever it may be found, no matter who commits it.\u0026nbsp; And we are using more tools than ever before to uncover misconduct and hold wrongdoers to account, whether they are executives in corner offices or doctors who violate their oaths.\u201d\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EToday\u2019s enforcement action was led and coordinated by the Health Care Fraud Unit of the Criminal Division\u2019s Fraud Section and its core partners: U.S. Attorneys\u2019 Offices, the Department of Health and Human Services Office of Inspector General (HHS-OIG), FBI, and Drug Enforcement Administration (DEA). The cases were investigated by agents from the division\u2019s core partner agencies along with other federal and state law enforcement agencies. The cases are being prosecuted by Health Care Fraud Strike Force teams from the Criminal Division\u2019s Fraud Section, 32 U.S. Attorneys\u2019 Offices nationwide, and 11 State Attorney Generals\u2019 Offices.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThis work is important to the Department of Health and Human Services (HHS) and the millions of Americans we serve. HHS vigorously pursues anyone who commits fraud against our health care programs. But it takes all of us, working together, to be successful,\u201d said HHS Deputy Secretary Andrea Palm. \u201cThose who steal from these programs are stealing from the American families who rely on them and putting patients at risk. We won\u2019t stop until all those who try to defraud the federal government are caught and held accountable.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cWe will not tolerate fraud that preys on patients who need and deserve high quality health care,\u201d said the HHS-OIG Inspector General Christi A. Grimm. \u201cThe hard work of the HHS-OIG team and our outstanding law enforcement partners makes today\u2019s action possible. We must protect taxpayer dollars and keep Americans safe from harms to their health, privacy, and financial well-being.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cu\u003EAmniotic Wound Grafts\u003C\/u\u003E\u003C\/p\u003E\n\n\u003Cp\u003ECharges were filed in the District of Arizona against four individuals who allegedly filed $900 million in false and fraudulent claims to Medicare for amniotic wound grafts used on Medicare patients. As alleged, the defendants targeted elderly Medicare patients, many of whom were terminally ill. The defendants caused medically unnecessary and expensive amniotic grafts to be applied to these vulnerable patients\u2019 wounds indiscriminately, without coordination with the patients\u2019 treating physicians and without proper treatment for infection, to superficial wounds that did not need this treatment, and in sizes that far exceeded the size of the wound. In just 16 months, Medicare paid two defendants more than $600 million as a result of their fraud scheme, paying on average more than a million dollars per patient for these unnecessary grafts. These two defendants owned wound care companies in Arizona and received more than $330 million in illegal kickbacks in exchange for purchasing the grafts billed to Medicare. In connection with the charges, the government seized over $70 million, including four luxury vehicles, gold, jewelry, and cash.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cEvery dollar saved by investigating fraud is critical to the sustainability of the Medicare program and the needs of the people who depend on it,\u201d said Administrator Chiquita Brooks-LaSure of the Centers for Medicare \u0026amp; Medicaid Services (CMS). \u201cIn addition to the actions taken by the Justice Department, CMS took 127 administrative actions in the last six months separately against providers for their alleged involvement in health care fraud schemes. We thank our partners at the Department of Justice and Department of Health and Human Services Office of Inspector General for working closely with us to identify, investigate, and eliminate waste, fraud, and abuse in our federal health care programs.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cu\u003EDistribution of Adderall and Other Stimulants\u003C\/u\u003E\u003C\/p\u003E\n\n\u003Cp\u003EFive additional defendants associated with digital technology company Done Global Inc. and its affiliated entity, Done Health P.C. (collectively, \u201cDone\u201d), were charged for the unlawful distribution of millions of Adderall pills. The CEO and Clinical President of Done \u003Ca href=\u0022https:\/\/links-1.govdelivery.com\/CL0\/https:%2F%2Fwww.justice.gov%2Fopa%2Fpr%2Ffounderceo-and-clinical-president-digital-health-company-arrested-100m-adderall-distribution%3Futm_medium=email%26utm_source=govdelivery\/1\/010001905adec643-97c6b7ea-6927-4721-ac64-d89d5504c51d-000000\/ZxTA00eWWaxzGesccH-oyMmTYPQmoLrHDm5d5r14rM8=359\u0022\u003Ewere charged on June 13\u003C\/a\u003E in a scheme to distribute Adderall and other stimulants over the internet. The charges announced today include those against one of the most prolific prescribers working for Done, a Florida nurse practitioner who prescribed over 1.5 million pills of Adderall and other stimulants to patients across the United States. The indictment alleges that the nurse practitioner prescribed Adderall and other stimulants without interaction with patients, pursuant to Done\u2019s \u201cauto-refill\u201d policy. This policy allowed patients to obtain continued prescriptions after an initial encounter without any further audio or visual interaction with a medical professional. This allegedly resulted in the nurse practitioner prescribing Adderall and other stimulants to individuals suffering from drug addiction and continuing to issue Adderall prescriptions for months after the overdose deaths of patients.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cDEA works tirelessly to protect the public from harm, be it cartels funneling fentanyl into our communities or medical providers caring more about profits than patients,\u201d said DEA Administrator Anne Milgram. \u201cThe CEO and clinical director of Done Global Inc. are charged with over-prescribing millions of unneeded stimulant pills, potentially putting patients in danger and exacerbating the current stimulant medicine shortage. The seriousness of these actions should not be understated. DEA will continue to hold anyone accountable who endangers the health and well-being of Americans.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cu\u003EDiverted HIV Medication\u003C\/u\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThree owners and executives of a wholesale distributor of pharmaceutical drugs were charged in connection with an alleged $90 million wire fraud conspiracy to introduce adulterated and misbranded HIV drugs into the market. The HIV drugs were allegedly acquired through unlawful \u201cbuyback\u201d schemes in which previously dispensed bottles of prescription drugs were bought from vulnerable patients. The defendants allegedly purchased these drugs from the black market and resold them to pharmacies throughout the country with falsified documentation designed to conceal the true source of the medication. Pharmacies then dispensed these diverted HIV medications to unsuspecting patients.\u0026nbsp;At times, patients received bottles labeled as their prescription medication, but the bottles contained a different drug entirely, with one patient passing out and remaining unconscious for 24 hours after taking an anti-psychotic drug thinking it was his prescribed HIV medication.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cu\u003EAddiction Treatment Cases\u003C\/u\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe addiction treatment cases announced today include charges filed in the District of Arizona and Southern District of Florida against four defendants in connection with more than $146 million of allegedly false and fraudulent claims for services for vulnerable patients seeking treatment for drug or alcohol addiction. As alleged in one of the indictments, one defendant paid kickbacks in exchange for the referral of patients recruited from the homeless population and Native American reservations. She then fraudulently billed Arizona Medicaid for substance abuse treatment services that were either never provided or were provided at a level that was so substandard that it failed to serve any treatment purpose. The defendant is charged with money laundering offenses for her lavish purchases with the fraud proceeds, as well as obstruction of justice for allegedly falsifying records in response to a grand jury subpoena for documents.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cu\u003ETelemedicine and Laboratory Fraud Cases\u003C\/u\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThirty-six defendants were charged in connection with the submission of over $1.1 billion in fraudulent claims to Medicare resulting from telemedicine schemes. For example, in separate cases involving similar schemes that were perpetrated by different criminal networks in the Southern District of Texas, Northern District of Texas, and District of New Jersey, clinical laboratory owners allegedly paid illegal kickbacks and bribes, including to telemedicine companies, in exchange for the referral of orders for unnecessary genetic testing. The results of these genetic tests\u2014which were supposed to detect genetic mutations that could indicate an elevated risk of cancer, cardiovascular disease, Parkinson\u2019s disease, and other serious illness\u2014were not used in the patients\u2019 treatment. Other telemedicine schemes included the unsealing of a complaint in the Eastern District of Virginia against a psychiatrist who allegedly submitted fraudulent claims based on minimal patient interactions, including for visits that lasted between 10 to 30 seconds. The continued focus on prosecuting health care fraud schemes involving telemedicine reflects the Department\u2019s commitment to rooting out these schemes, which has saved taxpayers \u003Ca href=\u0022https:\/\/links-1.govdelivery.com\/CL0\/https:%2F%2Fwww.justice.gov%2Fopa%2Fpr%2Fnational-enforcement-action-results-78-individuals-charged-25b-health-care-fraud%3Futm_medium=email%26utm_source=govdelivery\/1\/010001905adec643-97c6b7ea-6927-4721-ac64-d89d5504c51d-000000\/6NGKtMZOY1y_o0CMqhgvyAncAu1sGrxm7-dGhtki5rY=359\u0022\u003Ebillions of dollars\u003C\/a\u003E.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cu\u003ECases Involving the Illegal Prescription and Distribution of Opioids and Other Health Care Fraud Schemes \u003C\/u\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe other cases announced today charge 14 defendants with crimes related to the illegal prescription and distribution of opioids that resulted in millions in false billings, including several charges against medical professionals and others who prescribed unnecessary opioids, Suboxone, and other controlled substances.\u003C\/p\u003E\n\n\u003Cp\u003EAn additional 126 defendants are charged with various other health care fraud schemes involving over $450 million in false and fraudulent claims to Medicare, Medicaid, and private insurance companies for treatments that were medically unnecessary or never provided. Ten defendants across the country were charged in connection with fraudulent COVID-19 testing, including an over $65 million scheme charged in the Southern District of Florida.\u003C\/p\u003E\n\n\u003Cp\u003EThe Center for Program Integrity of the Centers for Medicare and Medicaid Services (CPI\/CMS) separately announced today that it took adverse administrative actions in the last six months against 127 medical providers for their alleged involvement in health care fraud.\u003C\/p\u003E\n\n\u003Cp\u003EPrincipal Assistant Deputy Chief Jacob Foster, Assistant Chief Rebecca Yuan, and Trial Attorney Miriam L. Glaser Dauermann of the Health Care Fraud Unit of the Criminal Division\u2019s Fraud Section led and coordinated today\u2019s enforcement action. The cases are being prosecuted by the Health Care Fraud Unit\u2019s National Rapid Response, Florida, Gulf Coast, Los Angeles, Midwest, Northeast, and Texas Strike Forces; U.S. Attorneys\u2019 Offices for the Southern District of Alabama, District of Arizona, Central District of California, Northern District of California, Southern District of California, District of Connecticut, Middle District of Florida, Southern District of Florida, Northern District of Illinois, Eastern District of Kentucky, Western District of Kentucky, Eastern District of Louisiana, Middle District of Louisiana, Western District of Louisiana, Eastern District of Michigan, Western District of Michigan, Southern District of Mississippi, District of Montana, District of New Jersey, Eastern District of New York, Eastern District of North Carolina, Western District of Oklahoma, District of Rhode Island, Eastern District of Tennessee, Middle District of Tennessee, Eastern District of Texas, Northern District of Texas, Southern District of Texas, Eastern District of Virginia, Western District of Virginia, Southern District of West Virginia, and Eastern District of Wisconsin; and State Attorney Generals\u2019 Offices for Arizona, California, Illinois, Indiana, Louisiana, New York, Oklahoma, Pennsylvania, Puerto Rico, Rhode Island, and South Dakota. The Health Care Fraud Unit\u2019s Data Analytics Team used cutting-edge data analytics to identify and support the investigations that led to these charges.\u003C\/p\u003E\n\n\u003Cp\u003EIn addition to the FBI, HHS-OIG, DEA, and CMS\/CPI, HSI, IRS Criminal Investigation, Department of Veterans Affairs Office of Inspector General, Defense Criminal Investigative Service, Department of Labor, United States Postal Service Office of Inspector General, and other federal, state, and local law enforcement agencies participated in the operation. The Medicaid Fraud Control Units of the states of Arizona, California, Connecticut, Florida, Illinois, Indiana, Kentucky, Louisiana, New York, North Carolina, Oklahoma, Pennsylvania, Puerto Rico, Rhode Island, South Dakota, Tennessee, Texas, and Virginia also participated in the investigation of many of the federal and state cases announced today.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EThe Fraud Section leads the Criminal Division\u2019s efforts to combat health care fraud through the Health Care Fraud Strike Force. Prior to the charges announced as part of today\u2019s nationwide enforcement action and since its inception in March 2007, the Health Care Fraud Strike Force, which operates in 27 districts, charged more than 5,400 defendants who collectively billed Medicare, Medicaid, and private health insurers more than $27 billion.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cem\u003EAn indictment, information, or complaint is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.\u003C\/em\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe following documents related to today\u2019s announcement are available on the Health Care Fraud Unit website through these links:\u003C\/p\u003E\n\n\u003Cul\u003E\n\u003Cli\u003E\u003Ca href=\u0022https:\/\/links-1.govdelivery.com\/CL0\/http:%2F%2Fwww.justice.gov%2Fcriminal%2Fcriminal-fraud%2Fhealth-care-fraud-unit%2F2024-national-health-care-fraud-enforcement-action%3Futm_medium=email%26utm_source=govdelivery\/1\/010001905adec643-97c6b7ea-6927-4721-ac64-d89d5504c51d-000000\/hLKu8GXkAaayzMBVou2zDuT-lAWbm44V88nLB2xSy7E=359\u0022\u003EGraphics and Resources\u003C\/a\u003E\u003C\/li\u003E\n\u003Cli\u003E\u003Ca href=\u0022https:\/\/links-1.govdelivery.com\/CL0\/http:%2F%2Fwww.justice.gov%2Fcriminal%2Fcriminal-fraud%2Fhealth-care-fraud-unit%2F2024-national-hcf-case-summaries%3Futm_medium=email%26utm_source=govdelivery\/1\/010001905adec643-97c6b7ea-6927-4721-ac64-d89d5504c51d-000000\/_PUvKCFZPrfP-wEQqnccVs-EvvctBBCGnJxhuc9YHok=359\u0022\u003ECase Descriptions\u003C\/a\u003E\u003C\/li\u003E\n\u003Cli\u003E\u003Ca href=\u0022https:\/\/links-1.govdelivery.com\/CL0\/https:%2F%2Fwww.justice.gov%2Fcriminal%2Fcriminal-fraud%2Fhealth-care-fraud-unit%2F2024-national-hcf-court-documents%3Futm_medium=email%26utm_source=govdelivery\/1\/010001905adec643-97c6b7ea-6927-4721-ac64-d89d5504c51d-000000\/qZRdWo15o636_QtTkDhIj1FRdoQC8CKD0dneJt5_FaY=359\u0022\u003ECourt Documents\u003C\/a\u003E\u003C\/li\u003E\n\u003C\/ul\u003E","changed":"\u003Ctime datetime=\u00222024-06-27T14:53:41-04:00\u0022\u003E1719514421\u003C\/time\u003E\n","component":[{"uuid":"42408f6b-4f4a-4762-b2b2-1130ea85b32f","name":"USAO - Virginia, Western"}],"created":"\u003Ctime datetime=\u00222024-06-27T14:51:16-04:00\u0022\u003E1719514276\u003C\/time\u003E\n","date":"1719489600","image":"","number":"","teaser":"","title":"National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 Billion in False Claims","topic":[{"uuid":"cce5d791-6b0b-462d-9a42-768179164d43","name":"Healthcare Fraud"}],"url":"https:\/\/www.justice.gov\/usao-wdva\/pr\/national-health-care-fraud-enforcement-action-results-193-defendants-charged-and-over","uuid":"e12eeeff-af76-4ff1-9796-4df77ffc1ae7"},{"attachment":"","body":"\u003Cp\u003E\u003Cb\u003EDETROIT\u003C\/b\u003E - Today, United States Attorney Dawn N. Ison announced criminal charges against six defendants in connection with alleged schemes to defraud Medicare. The charges filed in federal court in Detroit are part of the Justice Department\u2019s 2024 National Health Care Fraud Enforcement Action.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cIt 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,\u201d said Attorney General Merrick B. Garland. \u201cThe Justice Department will bring to justice criminals who defraud Americans, steal from taxpayer-funded programs, and put people in danger for the sake of profits.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cMedicare is an essential safety net for seniors and individuals with disabilities. The Department of Justice and my office are committed to investigating and prosecuting those who steal taxpayer funds intended to protect vulnerable members of our community,\u201d said United States Attorney Dawn N. Ison.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cWe will not tolerate fraud that preys on patients who need and deserve high quality health care,\u201d said the Honorable Christi A. Grimm, the Department of Health and Human Services Inspector General (HHS-OIG). \u201cThe hard work of the HHS-OIG team and our outstanding law enforcement partners makes today\u2019s action possible.\u0026nbsp; We must protect taxpayer dollars and keep Americans safe from harms to their health, privacy, and financial well-being.\u201d\u003C\/p\u003E\n\n\u003Cp\u003EThe charges announced today by U.S. Attorney Ison are part of a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 147 defendants for their alleged participation in health care fraud and opioid abuse schemes that resulted in the submission of over $2.5 billion in alleged false billings. The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets, and the government, in connection with the enforcement action, seized over $150 million in cash, luxury vehicles, gold, and other assets.\u003C\/p\u003E\n\n\u003Cp\u003EThe Eastern District of Michigan, in particular, worked with the Department\u2019s Criminal Division and the following law enforcement organizations to investigate and prosecute the cases filed during the enforcement period: the Department of Health and Human Services Office of Inspector General (HHS-OIG) and the Federal Bureau of Investigation.\u003C\/p\u003E\n\n\u003Cp\u003EThe following individuals have been charged in the Eastern District of Michigan:\u003C\/p\u003E\n\n\u003Cp\u003E\u2022\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Ibrahim Sammour, 63, and Bashier Sammour, 28, of Wayne County, Michigan, were charged by indictment with conspiracy to pay illegal kickbacks, Ibrahim Sammour was additionally charged with conspiracy to commit health care fraud and health care fraud, and Bashier Sammour was additionally charged with making false statements relating to health care matters, all in connection with an alleged scheme to fraudulently obtain over $2 million from Medicare. According to charging documents, the Sammours operated Individualized Home Health Care, P.C., through which they submitted false and fraudulent claims to Medicare for home health care services that were medically unnecessary, not provided as represented, or not rendered. Five others were also charged by information\u2014two registered nurses, two group home owners, and a licensed practical nurse\u2014for their involvement in the charged conspiracies. The case is being prosecuted by Trial Attorneys Shankar Ramamurthy and Jeff Crapko of the Midwest Strike Force.\u003C\/p\u003E\n\n\u003Cp\u003E\u2022\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Yvette Hardy, 60, of Wayne County, Michigan, was charged by information with health care fraud in connection with an alleged scheme to fraudulently obtain over $3.4 million in Medicare funds. According to the information, Hardy, who owned and operated Pebble Brook Care Agency LLC, caused the submission of false and fraudulent claims to Medicare for psychotherapy services that were not provided as represented or not rendered at all. The case is being prosecuted by Trial Attorney Shankar Ramamurthy of the Midwest Strike Force.\u003C\/p\u003E\n\n\u003Cp\u003E\u2022\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Ruby Scott, 53, of Oakland County, Michigan, was charged by indictment with a conspiracy to defraud the United States and to pay illegal health care kickbacks, as well as with paying illegal health care kickbacks, in connection with an alleged scheme to fraudulently obtain over $2.2 million in Medicare funds. According to the indictment, Scott, who owned and operated Delta Home Health Care LLC, caused the submission of claims to Medicare for home health care services obtained through the payment of illegal kickbacks to patient recruiters in violation of the Anti-Kickback Statute. The case is being prosecuted by Trial Attorneys Shankar Ramamurthy and Kelly Warner of the Midwest Strike Force.\u003C\/p\u003E\n\n\u003Cp\u003E\u2022\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Dr. Vijil Rahulan, 52, of Hyderabad, India, was charged by indictment with conspiracy to commit heath care fraud and health care fraud, in connection with an alleged scheme to fraudulently obtain over $82 million in Medicare funds. As alleged in the indictment, Rahulan caused the submission of false and fraudulent claims for DME and genetic testing that were medically unnecessary or otherwise ineligible for reimbursement through Medicare because they were not the product of a doctor-patient relationship and examination. The indictment further alleges that the defendant\u2019s fraudulent conduct resulted in over $28.7 million being paid by Medicare. The case is being prosecuted by Trial Attorneys Kelly Warner and Andres Almendarez of the Midwest Strike Force.\u003C\/p\u003E\n\n\u003Cp\u003E\u2022\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Amro Sharafeldin, 40, of Michigan, was charged by criminal complaint with a scheme to violate the Anti-Kickback Statute and illegally purchase Medicare beneficiary information, in connection with Sharafeldin\u2019s operation of Prestige Specialty Pharmacy (\u201cPrestige\u201d) in Sterling Heights, Michigan. As alleged in the complaint, Sharafeldin, through Prestige, agreed to pay kickbacks and bribes to illegally acquire Medicare beneficiary information, which he and others then used in February and March 2023 to bill Medicare more than $1 million for OTC COVID-19 tests, regardless of whether the Medicare beneficiary requested the test kits. The case is being prosecuted by Assistant U.S. Attorney Andrew Lievense of the U.S. Attorney\u2019s office for the Eastern District of Michigan.\u003C\/p\u003E\n\n\u003Cp\u003EA complaint, information, or indictment is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.\u003C\/p\u003E\n\n\u003Cp\u003EDescriptions of each case involved in today\u2019s enforcement action are available on the \u003Ca href=\u0022http:\/\/www.justice.gov\/criminal\/criminal-fraud\/health-care-fraud-unit\/2024-national-hcf-case-summaries\u0022\u003EDepartment\u2019s website here\u003C\/a\u003E.\u003C\/p\u003E","changed":"\u003Ctime datetime=\u00222024-06-27T15:27:41-04:00\u0022\u003E1719516461\u003C\/time\u003E\n","component":[{"uuid":"b67ce1d4-10d6-4ea1-b582-444dec4e8c1e","name":"USAO - Michigan, Eastern"}],"created":"\u003Ctime datetime=\u00222024-06-27T15:23:37-04:00\u0022\u003E1719516217\u003C\/time\u003E\n","date":"1719489600","image":"","number":"","teaser":"","title":"National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 Billion in False Claims","topic":[{"uuid":"cce5d791-6b0b-462d-9a42-768179164d43","name":"Healthcare Fraud"}],"url":"https:\/\/www.justice.gov\/usao-edmi\/pr\/national-health-care-fraud-enforcement-action-results-193-defendants-charged-and-over","uuid":"93b5bbc6-ede8-4e48-811e-02d6cd140175"},{"attachment":"","body":"\u003Cp\u003E\u003Cb\u003E\u003Ci\u003E38 Defendants Charged in the Southern District of Florida\u003C\/i\u003E\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003E\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EMIAMI - Today, U.S. Attorney Markenzy Lapointe announced criminal charges against thirty-eight defendants in connection with alleged health care fraud schemes prosecuted in the Southern District of Florida. The charges filed in federal court are part of the Justice Department\u2019s 2024 National Health Care Fraud Enforcement Action. The charges stem from various schemes to defraud government and private health care benefit programs by submitting false claims for items and services that were not needed and, in many instances, never provided as well as a scheme to unlawfully distribute adulterated and misbranded prescription medications.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cIt 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,\u201d said Attorney General Merrick B. Garland. \u201cThe Justice Department will bring to justice criminals who defraud Americans, steal from taxpayer-funded programs, and put people in danger for the sake of profits.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThe results of this coordinated law enforcement action demonstrate that the U.S. Attorney\u2019s Office for the Southern District of Florida is committed to combatting health care fraud through the prosecution of those who steal from taxpayer-funded programs, defraud Americans, and compromise our health care system,\u201d stated U.S. Attorney Markenzy Lapointe. \u201cOur Office and law enforcement partners will continue to fight health care fraud by holding those accountable, at all levels of the healthcare industry, who put profits above patient care and exploit patients and our invaluable health care programs.\u201d\u003C\/p\u003E\n\n\u003Cp\u003EThe charges announced today by U.S. Attorney Markenzy Lapointe for the Southern District of Florida are part of a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 193 defendants for their alleged participation in health care fraud and opioid abuse schemes that resulted in the submission of over $2.75 billion in alleged false billings. The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets, and the Government, in connection with the enforcement action, seized over $231 million in cash, luxury vehicles, gold, and other assets.\u003C\/p\u003E\n\n\u003Cp\u003EThe Health Care Fraud Unit\u2019s National Rapid Response, Florida, Gulf Coast, Los Angeles, Midwest, Northeast, and Texas Strike Forces; U.S. Attorneys\u2019 Offices for the Southern District of Alabama, District of Arizona, Central District of California, Northern District of California, Southern District of California, District of Connecticut, Middle District of Florida, Southern District of Florida, Northern District of Illinois, Eastern District of Kentucky, Western District to Kentucky, Eastern District of Louisiana, Middle District of Louisiana, Western District of Louisiana, Eastern District of Michigan, Western District of Michigan, Southern District of Mississippi, District of Montana, District of New Jersey, Eastern District of New York, Eastern District of North Carolina, Western District of Oklahoma, District of Rhode Island, Eastern District of Tennessee, Middle District of Tennessee, Eastern District of Texas, Northern District of Texas, Southern District of Texas, Eastern District of Virginia, Western District of Virginia, Southern District of West Virginia, and Eastern District of Wisconsin; and State Attorney Generals\u2019 Offices for Arizona, California, Illinois, Indiana, Louisiana, New York, Oklahoma, Pennsylvania, Puerto Rico, Rhode Island, and South Dakota are prosecuting the cases in the National Enforcement Action, with assistance from the Health Care Fraud Unit\u2019s Data Analytics Team. Descriptions of each case involved in today\u2019s enforcement action are available on the \u003Ca href=\u0022http:\/\/www.justice.gov\/criminal\/criminal-fraud\/health-care-fraud-unit\/2024-national-hcf-case-summaries\u0022\u003EDepartment\u2019s website here\u003C\/a\u003E.\u003C\/p\u003E\n\n\u003Cp\u003EThe Southern District of Florida, in particular, worked with the Department\u2019s Criminal Division and the following law enforcement organizations to investigate and prosecute the cases filed during the enforcement period: the Department of Health and Human Services Office of Inspector General (HHS-OIG), FBI, Florida Office of the Attorney General Medicaid Fraud Control Unit (MFCU) and U.S. Marshals Service (USMS).\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u201cWe will not tolerate fraud that preys on patients who need and deserve high quality health care,\u201d said the Honorable Christi A. Grimm, the Department of Health and Human Services Inspector General. \u201cThe hard work of the HHS-OIG team and our outstanding law enforcement partners makes today\u2019s action possible. \u0026nbsp;We must protect taxpayer dollars and keep Americans safe from harms to their health, privacy, and financial well-being.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThe numbers speak for themselves \u2013 193 defendants and over $2.75 billion in alleged false billings. Health care fraud in South Florida is a large and growing problem. This is why the FBI and our partners at the U.S. Attorney\u2019s Office for the Southern District of Florida, HHS-OIG and MFCU devote considerable time and resources to investigate, catch, and prosecute those committing this type of fraud,\u201d said Jeffrey B. Veltri, Special Agent in Charge of the FBI Miami Field Office. \u201cThe law enforcement professionals who unravel these scams are to be commended for their diligence and commitment.\u0026nbsp; Yet we need the public\u2019s help. If anyone suspects they are a victim of health care\u0026nbsp;fraud please call your local FBI office, the Florida Attorney General, or the HHS-OIG.\u0022\u003C\/p\u003E\n\n\u003Cp\u003E\u201cI am proud of our Medicaid Fraud Control Unit\u2019s work to fight fraud through this massive nationwide action, stopping fraudsters who stole billions from healthcare programs, including more than $15 million from Florida Medicaid. We will continue to take a hard stance against criminals looking to exploit taxpayer-funded programs,\u201d stated Florida Attorney General Ashley Moody.\u003C\/p\u003E\n\n\u003Cp\u003EThe following individuals have been charged in the Southern District of Florida:\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Ci\u003EU.S. v. Marco Antonio Ramos Izquierdo, et al\u003Cu\u003E.\u003C\/u\u003E, \u003C\/i\u003ECase No. 24-20238-CR-Becerra, Marco Antonio Ramos Izquierdo, 42, of Cuba, Marelys Ruiz Ulloa, 45, of Miami, Fla., Jakeline Canova Cebrian, 58, of Miami, Fla., Roberto Cisneros Cebrian, 53, of Miami, Fla., Jose Antonio Rio Roche, 53, of Miami, Fla., Reiniel Claro Estrada, 42, of Phoenix, Ariz., Maria De Los Angeles Abreu Perez, 37, of Houston, Tex., Nelson Enrique Gonzalez Diaz, 38, of Doral, Fla., Jonathan Jose Martinez Lambrano, 41, of Houston, Tex., Ana Maria Gomez Contreras, 42, of Houston, Tex., Levy Alberto Colina Garcia, 37, of Doral, Fla., and Gloria Guillibeth Diaz Salas, 34, of Doral, Fla., were charged by indictment with conspiracy to commit money laundering and money laundering for their role in distributing the proceeds of fourteen durable medical equipment (DME) companies. According to the indictment, Medicare and Medicaid paid these fourteen companies approximately $17,600,000 as a result of false and fraudulent claims for DME. The indictment details how the DME companies transferred approximately $3,906,649 of the fraud proceeds to shell companies, including those owned by Ramos Izquierdo, Ruiz Ulloa, Canova Cebrian, Cisneros Cebrian, Rio Roche, and Claro Estrada. Those defendants then made cash withdrawals from their shell companies and also wrote checks from the shell companies that received these fraud proceeds to individual check cashers, including individual checks between $4,000 and $9,000 totaling a combined approximate amount of $2,513,381 made out to Abreu Perez, Gonzalez Diaz, Martinez Lambrano, Gomez Contreras, Colina Garcia, and Diaz Salas. HHS-OIG, FBI Miami, USMS and MFCU investigated the case. Assistant U.S. Attorney Will J. Rosenzweig of the U.S. Attorney\u2019s Office for the Southern District of Florida is prosecuting the case. Assistant U.S. Attorney Marx Calderon of the U.S. Attorney\u2019s Office for the Southern District of Florida is handling asset forfeiture.\u003C\/p\u003E\n\n\u003Cp\u003E\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Ci\u003EU.S. v. Santiago Garcia Jorge,\u003C\/i\u003E Case No. 24-20237-CR-Altman, Santiago Garcia Jorge, 49, of Land O\u2019 Lakes, Fla., was charged by indictment with conspiracy to commit money laundering and money laundering for his role in distributing the proceeds of a fraudulent DME company. The indictment alleges that in connection with his role as the president and registered agent of Gold Medical Supply Inc., a company that submitted false and fraudulent claims to Medicare and Medicaid in the approximate amount of $7,498,260 and was paid approximately $1,402,478 by Medicare and Medicaid, Garcia Jorge transferred approximately $1,384,875 of the fraud proceeds to shell companies located in the Southern District of Florida. Garcia Jorge did so by writing approximately $174,990 in checks directly to those shell companies, but also by transferring approximately $1,209,855 to three other Gold Medical bank accounts that he controlled before then transferring them to the same shell companies. HHS-OIG, FBI Miami and MFCU investigated the case. Assistant U.S. Attorney Will J. Rosenzweig of the U.S. Attorney\u2019s Office for the Southern District of Florida is prosecuting the case. Assistant U.S. Attorney Marx Calderon of the U.S. Attorney\u2019s Office for the Southern District of Florida is handling asset forfeiture.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Ci\u003EU.S. v. Jorge Acosta\u003C\/i\u003E, Case No. 24-20270-CR-Gayles, Jorge Acosta, 55, of Land O\u2019 Lakes, Fla., was charged by information with conspiracy to commit health care fraud in connection with an alleged scheme to defraud various private insurance plans. According to the information, Acosta was a licensed physical therapist who worked at Phoenix Rehab Center Corp., a medical clinic based in Miami. Acosta\u2019s co-conspirators offered and paid kickbacks to patient recruiters in exchange for referring beneficiaries of Administrative Services Only (ASO) corporate insurance plans, held by employers JetBlue Airways and AT\u0026amp;T Inc. and administered by Blue Cross Blue Shield (BCBS), to Phoenix Rehab for various forms of physical therapy treatments that they did not need and in many cases never received. Acosta falsified and backdated claims forms for submission to BCBS that falsely and fraudulently represented that various health care benefits had been provided by Phoenix Rehab to beneficiaries of BCBS and ASO insurance plans managed by BCBS. FBI Miami investigated this case.\u0026nbsp; Assistant U.S. Attorney Will J. Rosenzweig of the U.S. Attorney\u2019s Office for the Southern District of Florida is prosecuting the case. Assistant U.S. Attorney Marx Calderon of the U.S. Attorney\u2019s Office for the Southern District of Florida is handling asset forfeiture.\u003C\/p\u003E\n\n\u003Cp\u003EIn\u003Cb\u003E \u003C\/b\u003E\u003Ci\u003EU.S. v. Omar Cabrera Hernandez\u003C\/i\u003E, Case No. 24-20245-CR-Damian, Omar Cabrera Hernandez, 55, of Miami, Fla., was charged by information with conspiracy to offer and pay health care kickbacks to patients.\u0026nbsp;Hernandez, as the administrator of the clinic Advanced Community Wellness Center, Inc. in Hialeah, Fla., participated in a conspiracy to pay patients illegal kickbacks to attend psychosocial rehabilitation services at the clinic which were then billed to Medicaid. This conduct resulted in an improper benefit of at least $400,597 and submission of claims to Medicaid totaling over approximately $3.5 million. HHS-OIG Miami, FBI Miami and MFCU investigated the case. Assistant U.S. Attorney Timothy Abraham of the U.S. Attorney\u2019s Office for the Southern District of Florida is prosecuting it.\u0026nbsp;Assistant U.S. Attorney Emily Stone of the U.S. Attorney\u2019s Office for the Southern District of Florida is handling asset forfeiture.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Ci\u003EU.S. v. Yordany Rivera Bermudez\u003C\/i\u003E, Case No. 24-20256-CR-Damian, Yordany Rivera Bermudez, 35, of Ft. Myers, Fla., was charged by indictment with health care fraud in connection with a scheme to defraud Medicare and Medicaid of nearly $3 million for DME that was never supplied to Medicare beneficiaries and Medicaid recipients. As alleged in the indictment, Rivera Bermudez was the president and operator of Acqualina Health Medical Solutions Inc. (Acqualina), a company located in North Miami, Fla., that purported to provide DME to eligible Medicare and Medicaid recipients. In a ten-month period, Acqualina submitted approximately $2.9 million in allegedly fraudulent health care claims to Medicare and Medicaid for DME that Acqualina never provided, and that Medicare and Medicaid recipients never requested or needed. As a result, Medicare and Medicaid paid approximately $1.2 million to Acqualina. HHS-OIG, FBI Miami and MFCU investigated the case. Special Assistant U.S. Attorney Marc Canzio of the U.S. Attorney\u2019s Office for the Southern District of Florida is prosecuting the case. Assistant U.S. Attorney Mitchell Hyman of the U.S. Attorney\u2019s Office for the Southern District of Florida is handling asset forfeiture.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Ci\u003EU.S. v. Jorge Luis Pajon Rodriguez\u003C\/i\u003E, Case No. 24-20260-CR-Williams, Jorge Luis Pajon Rodriguez, 58, of Miami, Fla., was charged by information with conspiracy to offer and pay health care kickbacks to patients in connection with a scheme to defraud Medicaid. As alleged in the information, Pajon Rodriguez, as the owner of the Miami clinic Gables Community Wellness Center, Inc., participated in a conspiracy to pay patients illegal kickbacks to attend psychosocial rehabilitation services at the clinic which were then billed to Medicaid. This conduct resulted in an improper benefit of at least $1,338,184 and approximately $6 million in claims to Medicaid. HHS-OIG Miami, FBI Miami and MFCU investigated the case.\u0026nbsp;Assistant U.S. Attorney Timothy Abraham of the U.S. Attorney\u2019s Office for the Southern District of Florida is prosecuting it.\u0026nbsp; Assistant U.S. Attorney Emily Stone of the U.S. Attorney\u2019s Office for the Southern District of Florida is handling asset forfeiture.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Ci\u003EU.S. v. Yoan Manuel Sanchez Cardet, et al\u003C\/i\u003E., Case No. 24-60112-CR-Leibowitz, Yoan Manuel Sanchez Cardet, 34, of Homestead, Fla., and Alain Cabrera Marquez, 48, of Austin, Tex., were charged by indictment with conspiracy to commit health care fraud and wire fraud in connection with an alleged scheme to fraudulently obtain more than $3.2 million in Medicare funds. According to the indictment, Sanchez Cardet was involved in arranging the purchase of a DME company, PRNX Medical Supply Corp., that was acquired for the sole purpose of submitting fraudulent claims to Medicare. According to the indictment, Sanchez Cardet was also involved in installing Cabrera Marquez as the sole listed officer of PRNX Medical who signed relevant documents on behalf of the company, in order to conceal the identities of the beneficial owners of the company. FBI and HHS-OIG investigated the case. Assistant U.S. Attorney Aimee C. Jimenez of the U.S. Attorney\u2019s Office for the Southern District of Florida is prosecuting it. Assistant U.S. Attorney Daren Grove of the U.S. Attorney\u2019s Office for the Southern District of Florida is handling asset forfeiture.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Ci\u003EU.S. v. Daniel David Espinoza\u003C\/i\u003E, Case No. 24-60105-CR-Singhal, Daniel David Espinoza, 55, of Parkland, Fla., was charged by information with conspiracy to commit money laundering for allegedly laundering illegal proceeds derived from a health care fraud scheme. According to the information, five DME companies received approximately $5 million from Medicare for the submission of false and fraudulent claims for DME that they did not actually provide and\/or was not medically necessary. Espinoza then laundered approximately $3.4 million of those fraud proceeds, primarily through his own company, Danoza Enterprises, and disbursed the proceeds to himself, his family, and others involved in the fraud. FBI and HHS-OIG investigated the case. Assistant U.S. Attorney Aimee C. Jimenez of the U.S. Attorney\u2019s Office for the Southern District of Florida is prosecuting it. Assistant U.S. Attorney Daren Grove of the U.S. Attorney\u2019s Office for the Southern District of Florida is handling asset forfeiture.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Ci\u003EU.S. v. Justin Blair and Trevor Blair,\u003C\/i\u003E Case No. 24-cr-80074-Middlebrooks, Justin Blair, 34, and Trevor Blair, 30, both of Boca Raton, Fla,, were charged by indictment with conspiracy to defraud the United States and to receive health care kickbacks, solicitation and receipt of kickbacks in connection with a federal health care program, conspiracy to commit money laundering, and money laundering in connection with an alleged kickback scheme involving a laboratory based in Texas. As alleged in the indictment, Justin Blair and Trevor Blair were partners in PIC Group 21, LLC (PIC Group), a call center that conducted deceptive telemarketing to persuade Medicare beneficiaries and their doctors to order genetic tests. PIC Group allegedly sold signed orders to the lab, which billed Medicare more than $3.5 million based on the orders from PIC Group. PIC Group allegedly received more than $2.5 million in kickbacks and laundered the proceeds through entities controlled by the defendants. HHS-OIG and FBI investigated the case. The case is being prosecuted by Trial Attorney Owen Dunn of the Florida Strike Force. Assistant U.S. Attorney Mitchell Hyman of the U.S. Attorney\u2019s Office for the Southern District of Florida is handling asset forfeiture.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Ci\u003EU.S. v. Enrique Perez-Paris et al\u003C\/i\u003E., Case No. 24-cr-20155-Ruiz, Enrique Perez-Paris, 47, of Aventura, Fla.; Diego Sanudo Sanchez Chocron, 47, of Venice, Calif.; Gregory Charles \u201cMilo\u201d Caskey, 57, of San Antonio, Tex.; Omar Palacios, 34, of Miami, Fla.; and Nadir Perez, 26, of Miami, Fla., were charged by superseding indictment with conspiracy to commit health care fraud, health care fraud, conspiracy to defraud the United States and to pay and receive health care kickbacks, and conspiracy to commit money laundering in connection with an alleged $65 million scheme to bill health care benefit programs, including Medicare and the Health Resources and Services Administration COVID-19 Uninsured Program, for medically unnecessary and otherwise non-reimbursable COVID-19 and genetic testing. Palacios and Perez were also charged with receipt of kickbacks in connection with a federal health care program. As alleged in the superseding indictment, Perez-Paris, Sanchez, and Caskey owned Innovative Genomics, an independent clinical laboratory in San Antonio. Perez-Paris, Sanchez, and Caskey paid kickbacks and bribes to physicians and patient recruiters, including Palacios and Perez, to generate orders for COVID-19 and genetic testing that Innovative Genomics would use to support false and fraudulent claims for reimbursement. The defendants also caused health care benefit programs to be billed for COVID-19 testing that the Food and Drug Administration had not approved for emergency-use authorization. The defendants further caused Medicare to be billed for genetic testing that patients did not need, that was procured by payments made directly to physicians, and that Innovative Genomics did not process. HHS-OIG and FBI investigated the case. Trial Attorney Reginald Cuyler Jr. of the Florida Strike Force is prosecuting the case. Assistant U.S. Attorney Marx Calderon of the U.S. Attorney\u2019s Office for the Southern District of Florida is handling asset forfeiture.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Ci\u003EU.S. v. Adam Brosius, et al.\u003C\/i\u003E, Case No. 24-cr-20255-Dimitrouleas, Adam Brosius, 59, of Delray Beach, Fla., and Patrick Boyd, 43, and Charles Boyd, 46, both of Easton, Md. were charged by indictment with conspiracy to introduce into interstate commerce adulterated and misbranded drugs and to defraud the United States;\u0026nbsp;introducing into interstate commerce misbranded drugs;\u0026nbsp;conspiracy to traffic in medical products with false documentation; conspiracy to commit wire fraud; and wire fraud. As alleged in the indictment, Patrick Boyd and Charles Boyd were the owners of Safe Chain Solutions LLC (Safe Chain), a wholesale distributor of pharmaceutical drugs. Brosius was a part owner of Safe Chain and the owner of Worldwide Pharma Sales Group, Inc., which helped Safe Chain locate suppliers of HIV drugs and pharmacy customers to purchase HIV drugs. According to the indictment, Safe Chain purchased more than $90 million of heavily discounted and diverted prescription drugs, primarily HIV medication, from five black-market suppliers. These diverted HIV drugs were often acquired through unlawful \u201cbuyback\u201d schemes, in which previously dispensed bottles of prescription drugs were purchased from patients. The drugs were then resold to Safe Chain with falsified documentation designed to conceal the true source of the medications. After purchasing HIV medication from the black-market suppliers, the defendants sold the diverted drugs to pharmacies throughout the country. Pharmacies then dispensed these diverted HIV medications to unsuspecting patients. At times, patients received bottles labeled as their prescription medication, but the bottles contained a different drug entirely, with one patient passing out and remaining unconscious for 24 hours after taking an anti-psychotic drug thinking it was his prescribed HIV medication. FBI and HHS-OIG investigated the case. The case is being prosecuted by Trial Attorneys Alexander Thor Pogozelski of the Market Integrity and Major Frauds Unit and Jacqueline DerOvanesian of the Florida Strike Force. Assistant U.S. Attorney Jorge Delgado of the U.S. Attorney\u2019s Office for the Southern District of Florida is assisting with asset forfeiture.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Ci\u003EIn U.S. v. Alicia Hiller,\u003C\/i\u003E Case No. 24-80079-CR-Rosenberg, Alicia Hiller, 45, of Pompano Beach, Fla., was charged by indictment with conspiracy to commit wire fraud and health care fraud, and health care fraud, in connection with her role in an unlawful scheme to defraud Medicare by submitting false and fraudulent claims for medically unnecessary DME. As alleged in the indictment, Hiller was the owner of Lifeline Recruiting, Inc. (Lifeline), which she used to pay medical providers to sign prescriptions for DME, even though the providers were not reviewing the beneficiaries\u2019 medical records and were not making an actual assessment of medical necessity. Hiller described these providers as \u201chappy clickers\u201d or \u201cauto-clickers.\u201d\u0026nbsp;Those prescriptions were then used to submit false and fraudulent claims to Medicare for the medically unnecessary DME. As a result of the scheme, Medicare paid more than $40 million on the false and fraudulent claims. HHS-OIG and FBI investigated the case. Trial Attorney Raymond Beckering III of the National Rapid Response Strike Force is prosecuting the case. Assistant U.S. Attorney Emily Stone of the U.S. Attorney\u2019s Office for the Southern District of Florida is assisting with asset forfeiture.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Ci\u003EU.S. v. Wesley Jackson\u003C\/i\u003E, Case No. 24-cr-20269-Smith, Wesley Jackson, 28, of Long Island City, N.Y., was charged by information with health care fraud in connection with an alleged scheme to fraudulently bill Medicare for over $2.1 million for medically unnecessary orthotic braces, using sham contracts and invoices to disguise the payments.\u0026nbsp;According to the information, Jackson,\u0026nbsp;the owner of a marketing company called Jackson Media LLC, sold doctors\u2019 orders for medically unnecessary orthotic braces to DME suppliers in exchange for kickbacks and bribes.\u0026nbsp;HHS-OIG and MFCU investigated the case.\u0026nbsp; The case is being prosecuted by Trial Attorney Jacqueline DerOvanesian of the Florida Strike Force. Assistant U.S. Attorney Jorge Delgado of the U.S. Attorney\u2019s Office for the Southern District of Florida is assisting with asset forfeiture.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Ci\u003EU.S. v. Ryan Michael Pattrin\u003C\/i\u003E, Case No. 24-cr-60109-Leibowitz, Ryan Michael Pattrin, 48, of Fort Lauderdale, Fla., was charged by indictment with conspiracy to commit health care fraud and wire fraud, conspiracy to defraud the United States and to pay and receive health care kickbacks, and solicitation and receipt of kickbacks. According to the indictment, Pattrin was one of the owners of Infinity Medical Supply LLC, a DME company that billed Medicare for medically unnecessary DME based on doctors\u2019 orders procured through illegal kickbacks and bribes. The indictment also alleges that Pattrin was one of the owners of National Health Care Advocates LLC, a purported marketing company that referred doctors\u2019 orders for DME to DME companies in exchange for illegal kickbacks and bribes. The indictment alleges that Pattrin and his co-conspirators caused DME companies, including Infinity, to submit over $7.9 million in false and fraudulent claims to Medicare. HHS-OIG and FBI investigated the case. The case is being prosecuted by Trial Attorney Andrea Savdie of the Florida Strike Force. Assistant U.S. Attorney G. Raemy Charest-Turken of the U.S. Attorney\u2019s Office for the Southern District of Florida is handling asset forfeiture.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Ci\u003EU.S. v. Michael Cascone, \u003C\/i\u003ECase No.\u003Ci\u003E \u003C\/i\u003E24-cr-20243-Singhal, Michael Cascone, 31, of Delray Beach, Fla., was charged by information with conspiracy to commit health care fraud. According to the information, Cascone owned two DME companies, Limitless Medical Supplies, LLC and Your Medical Supply Co, LLC, that paid illegal kickbacks and bribes to a purported marketing company in exchange for referring beneficiaries and doctors\u2019 orders for DME that was medically unnecessary and ineligible for reimbursement by Medicare. The information alleges that through Limitless Medical Supplies, LLC and Your Medical Supply Co, LLC, Cascone submitted approximately $3,493,466 in false and fraudulent claims for reimbursement from Medicare. HHS-OIG and FBI investigated the case. The case is being prosecuted by Trial Attorney Andrea Savdie of the Florida Strike Force. Assistant U.S. Attorney G. Raemy Charest-Turken of the U.S. Attorney\u2019s Office for the Southern District of Florida is handling asset forfeiture.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Ci\u003EU.S. v. Angelica Pacheco\u003C\/i\u003E, Case No. 24-cr-20253-Becerra, Angelica Pacheco, 37, of Hialeah, Fla., was charged by indictment with conspiracy to commit health care fraud and wire fraud, health care fraud, and wire fraud in a sober home scheme involving $19.2 million billed to private insurers. Pacheco owned and operated Florida Life Recovery and Rehabilitation LLC (Florida Life) which purportedly provided several levels of outpatient substance abuse care. As alleged in the indictment, Pacheco submitted or caused the submission of false and fraudulent claims to private insurers for therapy services that were not provided, or were not provided as billed, and excessive and medically unnecessary urinalyses that were not factored into patient treatment. The indictment further alleges that Pacheco fraudulently obtained Paycheck Protection Program (PPP) and Economic Injury Disaster Loan Program (EIDL) loans on behalf of Florida Life by falsely certifying that the company was not engaged in any illegal activities. In November 2023, Pacheco was elected to the City Council for the City of Hialeah. FBI investigated this case. The case is being prosecuted by Assistant Chief James Hayes of the National Rapid Response Strike Force and Trial Attorney Aisha Schafer Hylton of the Florida Strike Force. Assistant U.S. Attorney Joshua Paster of the U.S. Attorney\u2019s Office for the Southern District of Florida is handling asset forfeiture.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Ci\u003EU.S. v. Smith et al.\u003C\/i\u003E, Case No. 24-cr-20268-Becerra, Deborah Smith, 62, of Hialeah, Fla., and Mabel de la Caridad Rodriguez Brito, 53, of Miami, Fla., were charged by information with conspiracy to commit health care fraud in connection with an alleged scheme to fraudulently obtain over $58,000 in Medicare funds. According to the information, Smith and Rodriguez were employees at a medical facility, and sold Medicare patient information in exchange for cash. That patient information was later used to submit false and fraudulent claims to Medicare for durable medical equipment that was never provided and\/or was medically unnecessary and ineligible for reimbursement by Medicare. HHS-OIG and FBI investigated the case. The case is being prosecuted by Trial Attorney Jessica A. Massey of the Florida Strike Force and Health Care Fraud Unit Assistant Chief Emily Gurskis. Assistant U.S. Attorneys G. Raemy Charest-Turken and Jorge Delgado of the U.S. Attorney\u2019s Office for the Southern District of Florida are handling asset forfeiture.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Ci\u003EU.S. v. Betscy Kurian\u003C\/i\u003E, Case No. 24-cr-60114-Singhal, Betscy Kurian, 59, of Coral Springs, Fla., was charged by information with conspiracy to distribute and dispense controlled substances, in connection with a scheme to dispense controlled substances, primarily oxycodone. As alleged in the information, Kurian, a pharmacist, dispensed oxycodone knowing that these prescriptions were not written in the course of professional practice for a legitimate medical purpose. HHS-OIG and FBI investigated the case.\u0026nbsp; The case is being prosecuted by Trial Attorney Jacqueline DerOvanesian of the Florida Strike Force. Assistant U.S. Attorney Jorge Delgado of the Southern District of Florida is handling asset forfeiture.\u003C\/p\u003E\n\n\u003Cp\u003EIn \u003Ci\u003EU.S. v. Lianet Sacerio\u003C\/i\u003E, Case No. 24-20267-CR-Ruiz, Lianet Sacerio, 38, of Miami, Fla., was charged by information with obstruction of criminal investigations of health care offenses. As charged in the information, from March 2022 through March 2023, Sacerio made false representations to law enforcement agents regarding her own knowledge, involvement, and financial interest in health care fraud offenses under investigation. FBI Miami investigated the case. Assistant U.S. Attorneys Joseph Egozi and Lindsey Lazopoulos Friedman of the Southern District of Florida are prosecuting it.\u0026nbsp;Assistant U.S. Attorney Joshua Paster of the Southern District of Florida is handling asset forfeiture.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u003Ci\u003EA complaint, information, or indictment is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.\u003C\/i\u003E\u003C\/p\u003E\n\n\u003Cp\u003EYou may find a copy of this press release (and any updates) on the website of the United States Attorney\u2019s Office for the Southern District of Florida at \u003Ca href=\u0022http:\/\/www.usdoj.gov\/usao\/fls\u0022\u003Ewww.usdoj.gov\/usao\/fls\u003C\/a\u003E.\u003C\/p\u003E\n\n\u003Cp\u003ERelated court documents and information may be found on the website of the District Court for the Southern District of Florida at \u003Ca href=\u0022http:\/\/www.flsd.uscourts.gov\u0022\u003Ewww.flsd.uscourts.gov\u003C\/a\u003E or at \u003Ca href=\u0022http:\/\/pacer.flsd.uscourts.gov\u0022\u003Ehttp:\/\/pacer.flsd.uscourts.gov\u003C\/a\u003E.\u003C\/p\u003E\n\n\u003Cp\u003E###\u003C\/p\u003E","changed":"\u003Ctime datetime=\u00222024-06-27T15:55:04-04:00\u0022\u003E1719518104\u003C\/time\u003E\n","component":[{"uuid":"7134133d-a27a-4c2c-8c45-cdc1da8e9c1a","name":"USAO - Florida, Southern"}],"created":"\u003Ctime datetime=\u00222024-06-27T15:51:04-04:00\u0022\u003E1719517864\u003C\/time\u003E\n","date":"1719489600","image":"","number":"","teaser":"\u003Cp\u003EToday, U.S. Attorney Markenzy Lapointe announced criminal charges against thirty-eight defendants in connection with alleged health care fraud schemes prosecuted in the Southern District of Florida. The charges filed in federal court are part of the Justice Department\u2019s 2024 National Health Care Fraud Enforcement Action. The charges stem from various schemes to defraud government and private health care benefit programs by submitting false claims for items and services that were not needed and, in many instances, never provided as well as a scheme to unlawfully distribute adulterated and misbranded prescription medications.\u003C\/p\u003E","title":"National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 Billion in False Claims","topic":[{"uuid":"cce5d791-6b0b-462d-9a42-768179164d43","name":"Healthcare Fraud"}],"url":"https:\/\/www.justice.gov\/usao-sdfl\/pr\/national-health-care-fraud-enforcement-action-results-193-defendants-charged-and-over","uuid":"c12601d6-b5a8-4621-8986-c52c29d052c7"},{"attachment":"","body":"\u003Cp\u003ENEWARK, N.J. \u2013 Today, U.S. Attorney Philip R. Selliniger, District of New Jersey, \u0026nbsp;announced criminal charges against 13 defendants in connection with alleged schemes to defraud Medicare, Medicaid, TRICARE, and private health insurers. The charges filed in federal court are part of the Department of Justice\u2019s 2024 National Health Care Fraud Enforcement Action.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cIt 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,\u201d said Attorney General Merrick B. Garland. \u201cThe Justice Department will bring to justice criminals who defraud Americans, steal from taxpayer-funded programs, and put people in danger for the sake of profits.\u201d\u003C\/p\u003E\n\n\n\u003Cblockquote cite=\u0022USAtty\u0022\u003E\n\u003Cp\u003E\u201cPatients rely on Medicare and other health insurers to cover the costs of necessary care, and the system is built on trust. Health care providers and others who take advantage of that system through fraud or illegal kickbacks reap unwarranted profits and undermine the system.\u0026nbsp;The cases announced today \u2013 part of a nationwide action against 193 defendants allegedly resulting in over $2.75 billion in alleged false billings, and the seizure of over $231 million in cash, luxury vehicles, gold and other assets \u2013 allege a variety of misconduct, but they all seek to hold accountable those who put profits over patients.\u0026nbsp;Along with our law enforcement partners, this office is committed to safeguarding Medicare and the health care system from fraud and illegal kickback schemes.\u201d\u003C\/p\u003E\n\u003C\/blockquote\u003E\n\nU.S. Attorney Philip R. Sellinger\n\n\n\u003Cp\u003EThe charges announced today by U.S. Attorney Sellinger are part of a strategically coordinated, two-week nationwide law enforcement action.\u003C\/p\u003E\n\n\u003Cp\u003EThe Health Care Fraud Unit\u2019s National Rapid Response, Florida, Gulf Coast, Los Angeles, Midwest, Northeast, and Texas Strike Forces; U.S. Attorneys\u2019 Offices for the District of New Jersey, the Southern District of Alabama, District of Arizona, Central District of California, Northern District of California, Southern District of California, District of Connecticut, Middle District of Florida, Southern District of Florida, Northern District of Illinois, Eastern District of Kentucky, Western District of Kentucky, Eastern District of Louisiana, Middle District of Louisiana, Western District of Louisiana, Eastern District of Michigan, Western District of Michigan, Southern District of Mississippi, District of Montana, Eastern District of New York, Southern District of New York, Eastern District of North Carolina, Western District of Oklahoma, District of Rhode Island, Middle District of Tennessee, Northern District of Texas, Southern District of Texas, Eastern District of Tennessee, Eastern District of Virginia, and Southern District of West Virginia; and the State Attorney Generals\u2019 Offices for California, New York, Pennsylvania, Puerto Rico, Rhode Island, and South Dakota are prosecuting the cases in the National Enforcement Action, with assistance from the Health Care Fraud Unit\u2019s Data Analytics Team. Descriptions of each case involved in today\u2019s enforcement action are available on the \u003Ca href=\u0022https:\/\/www.justice.gov\/criminal\/criminal-fraud\/health-care-fraud-unit\/2024-national-hcf-case-summaries\u0022\u003EDepartment\u0027s website here.\u003C\/a\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe District of New Jersey worked with the Department\u2019s Criminal Division and other law enforcement organizations to investigate and prosecute the cases filed during the enforcement period.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cWe will not tolerate fraud that preys on patients who need and deserve high quality health care,\u201d said the Honorable Christi A. Grimm, the Department of Health and Human Services Inspector General (HHS-OIG). \u201cThe hard work of the HHS-OIG team and our outstanding law enforcement partners makes today\u2019s action possible. We must protect taxpayer dollars and keep Americans safe from harms to their health, privacy, and financial well-being.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThe Defense Criminal Investigative Service (DCIS), the law enforcement arm of the Department of Defense Office of Inspector General, is fully committed to working with our law enforcement partners and the Justice Department to hold those who engage in fraudulent activity at the expense of the U.S. military accountable for their actions,\u201d Acting Special Agent-in-Charge Brian J. Solecki of the DCIS Northeast Field Office, said.\u0026nbsp;\u201cProtecting the integrity of the healthcare system utilized by our military members and their families is of the utmost importance and continues to be a top priority for DCIS.\u201d\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u201cWe remain fully committed to bringing justice to those who steal from Amtrak\u2019s resources, including these current and former Amtrak employees accused of defrauding Amtrak\u2019s health care plans,\u201d Amtrak\u2019s Inspector General, Kevin H. Winters, said. \u201cThe alleged actions by these employees and health care providers drained millions in Amtrak\u2019s funds \u2013 resources ultimately provided by American taxpayers \u2013 and we hope these charges will serve as a deterrent for those considering engaging in such schemes. Anyone who suspects or observes such fraud should report it to our investigators via our fraud, waste, and abuse hotline.\u201d\u003C\/p\u003E\n\n\u003Cp\u003EThe following individuals have been charged in District of New Jersey:\u003C\/p\u003E\n\n\u003Cul\u003E\n\u003Cli\u003E\u003Cb\u003EKimberlee Otero\u003C\/b\u003E, 47, of Camden, New Jersey, was charged by information with conspiracy to unlawfully distribute and possess with intent to distribute a controlled substance. The case is being prosecuted by Trial Attorney Nicholas K. Peone of the Northeast Strike Force and Assistant U.S. Attorney Jeffrey Bender of the U.S. Attorney\u2019s Office for the District of New Jersey.\u003C\/li\u003E\n\u003Cli\u003E\u003Cb\u003EHyunji Choi\u003C\/b\u003E, aka \u201cRegina Choi,\u201d aka \u201cRegina Beatrice,\u201d 39, of Woodside, New York, was charged by information with conspiracy to commit health care fraud in connection with a scheme to defraud the Amtrak health care plan. As alleged in the information, Choi, a medical biller, submitted false and fraudulent claims to the Amtrak health care plan for services that were not provided, resulting in loss to the Amtrak health care plan of at least approximately $959,902.79. Choi paid cash bribes and kickbacks to co-conspirator Amtrak employees, in return for the employees\u2019 agreement to allow their insurance to be used for false billing. The case is being prosecuted by Assistant U.S. Attorneys Katherine M. Romano and Jessica R. Ecker of the U.S. Attorney\u2019s Office for the District of New Jersey.\u003C\/li\u003E\n\u003Cli\u003E\u003Cb\u003ETimothy Bogen\u003C\/b\u003E, 59, of Hamden, Connecticut, \u003Cb\u003EKevin Frink\u003C\/b\u003E, 52, of Willingboro, New Jersey, \u003Cb\u003EDion Jacob\u003C\/b\u003E, 50, of Brooklyn, New York, \u003Cb\u003EQuinton Johnson\u003C\/b\u003E, 52, of Irvington, New Jersey, \u003Cb\u003EDavid Lonergan\u003C\/b\u003E, 64, of Rockaway Park, New York, \u003Cb\u003EDavid McBrien\u003C\/b\u003E, 36, of Levittown, Pennsylvania, \u003Cb\u003EGregory Richardson,\u003C\/b\u003E 34, of Roosevelt, New York, \u003Cb\u003ERodolfo Rivera\u003C\/b\u003E, 41, of Clayton, Delaware, \u003Cb\u003EMichael Toal\u003C\/b\u003E, 34, of Hazlet, New Jersey, and \u003Cb\u003EDamany Walker\u003C\/b\u003E, 41, of Irvington, New Jersey, were charged by indictment with conspiracy to commit health care fraud in connection with a scheme to defraud the Amtrak health care plan, which resulted in a loss of approximately $11,054,831 to Amtrak. The defendants were Amtrak employees and participants in the Amtrak health care plan who allowed their personal and insurance information, and in some cases that of their dependents, to be used for false and medically unnecessary billing in return for cash kickbacks and bribes paid by co-conspirator health care providers. The case is being prosecuted by Assistant U.S. Attorneys Katherine M. Romano and Jessica R. Ecker of the U.S. Attorney\u2019s Office for the District of New Jersey.\u003C\/li\u003E\n\u003Cli\u003E\u003Cb\u003EElise Nocella\u003C\/b\u003E, 54, of Naples, Florida, was charged by information with conspiring to violate the Anti-Kickback Statute by paying kickbacks for DME orders. As alleged in the information, Nocella, who owned and operated a marketing company that marketed DME, offered and paid physicians at a pain management practice kickbacks in exchange for DME orders. Nocella supplied the physicians with a variety of expensive items, including cash, full-season access to a suite for professional football games, expensive lunches and dinners at networking events and practice group meetings, and other expensive gifts, and subsequently billed Medicare and other health care benefit programs for the orders. The case is being prosecuted by Assistant U.S. Attorney DeNae Thomas of the U.S. Attorney\u2019s Office for the District of New Jersey.\u003C\/li\u003E\n\u003C\/ul\u003E\n\n\u003Cp\u003EA complaint, information, or indictment is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.\u003C\/p\u003E","changed":"\u003Ctime datetime=\u00222024-06-27T22:37:13-04:00\u0022\u003E1719542233\u003C\/time\u003E\n","component":[{"uuid":"b1284e54-1a64-49f4-82c3-b02081ffee19","name":"USAO - New Jersey"}],"created":"\u003Ctime datetime=\u00222024-06-27T15:54:54-04:00\u0022\u003E1719518094\u003C\/time\u003E\n","date":"1719489600","image":"","number":"24-248","teaser":"\u003Cp\u003ENEWARK, N.J. \u2013 Today, U.S. Attorney Philip R. Selliniger, District of New Jersey, \u0026nbsp;announced criminal charges against 13 defendants in connection with alleged schemes to defraud Medicare, Medicaid, TRICARE, and private health insurers. The charges filed in federal court are part of the Department of Justice\u2019s 2024 National Health Care Fraud Enforcement Action.\u003C\/p\u003E","title":"National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 Billion in False Claims","topic":[{"uuid":"cce5d791-6b0b-462d-9a42-768179164d43","name":"Healthcare Fraud"}],"url":"https:\/\/www.justice.gov\/usao-nj\/pr\/national-health-care-fraud-enforcement-action-results-193-defendants-charged-and-over","uuid":"a083091f-d37d-4610-ad80-00178df05e66"},{"attachment":"","body":"\u003Cp\u003EBILLINGS \u2014\u0026nbsp;Today, U.S. Attorney Jesse Laslovich, for the District of Montana, announced criminal charges against a Whitefish physician in connection with alleged schemes to defraud Medicare and other government health program. The charges filed in federal court are part of the Justice Department\u2019s 2024 National Health Care Fraud Enforcement Action. The charges stem from fraudulently charging Medicare and other government health programs for telemedicine office visits that did not occur.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cIt 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,\u201d said Attorney General Merrick B. Garland. \u201cThe Justice Department will bring to justice criminals who defraud Americans, steal from taxpayer-funded programs, and put people in danger for the sake of profits.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cAs alleged, the defendant, Ronald David Dean, falsely billed Medicare and other health programs so he could enrich himself by diverting government health care funds meant to help elderly and disabled persons. Specifically, we allege he billed for telemedicine visits that did not occur and signed orders for durable medical equipment and covid-19 tests patients did not need, all of which resulted in over $39 million in false billing. As this action shows, we are committed to aggressively investigating and prosecuting those who try to defraud our health care programs,\u201d U.S. Attorney Laslovich said.\u003C\/p\u003E\n\n\u003Cp\u003EAn information charging Dean, along with a plea agreement, was filed on June 24. An arraignment and plea hearing are scheduled for July 17 in U.S. District Court in Missoula.\u003C\/p\u003E\n\n\u003Cp\u003EThe charges announced today by U.S. Attorney Laslovich are part of a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 193 defendants for their alleged participation in health care fraud and opioid abuse schemes that resulted in the submission of over $2.75 billion in alleged false billings. The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets, and the Government, in connection with the enforcement action, seized over $231 million in cash, luxury vehicles, gold, and other assets.\u003C\/p\u003E\n\n\u003Cp\u003EThe Health Care Fraud Unit\u2019s National Rapid Response, Florida, Gulf Coast, Los Angeles, Midwest, Northeast, and Texas Strike Forces; U.S. Attorneys\u2019 Offices for the Southern District of Alabama, District of Arizona, Central District of California, Northern District of California, Southern District of California, District of Connecticut, Middle District of Florida, Southern District of Florida, Northern District of Illinois, Eastern District of Kentucky, Western District to Kentucky, Eastern District of Louisiana, Middle District of Louisiana, Western District of Louisiana, Eastern District of Michigan, Western District of Michigan, Southern District of Mississippi, District of Montana, District of New Jersey, Eastern District of New York, Eastern District of North Carolina, Western District of Oklahoma, District of Rhode Island, Eastern District of Tennessee, Middle District of Tennessee, Eastern District of Texas, Northern District of Texas, Southern District of Texas, Eastern District of Virginia, Western District of Virginia, Southern District of West Virginia, and Eastern District of Wisconsin; and State Attorney Generals\u2019 Offices for Arizona, California, Illinois, Indiana, Louisiana, New York, Oklahoma, Pennsylvania, Puerto Rico, Rhode Island, and South Dakota are prosecuting the cases in the National Enforcement Action, with assistance from the Health Care Fraud Unit\u2019s Data Analytics Team. Descriptions of each case involved in today\u2019s enforcement action are available on the \u003Ca href=\u0022http:\/\/www.justice.gov\/criminal\/criminal-fraud\/health-care-fraud-unit\/2024-national-hcf-case-summaries\u0022\u003EDepartment\u2019s website here\u003C\/a\u003E.\u003C\/p\u003E\n\n\u003Cp\u003EThe District of Montana, in particular, worked with the Department\u2019s Criminal Division and the following law enforcement organizations to investigate and prosecute the cases filed during the enforcement period: the Department of Health and Human Services Office of Inspector General (HHS-OIG), Department of Veterans Affairs Office of Inspector General (VA-OIG) and Railroad Retirement Board Office of Inspector General.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cWe will not tolerate fraud that preys on patients who need and deserve high quality health care,\u201d said the Honorable Christi A. Grimm, the Department of Health and Human Services Inspector General (HHS-OIG). \u201cThe hard work of the HHS-OIG team and our outstanding law enforcement partners makes today\u2019s action possible. \u0026nbsp;We must protect taxpayer dollars and keep Americans safe from harms to their health, privacy, and financial well-being.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cThe defendant\u2019s agreement to plead guilty will hold him accountable for his fraudulent actions and reflects the magnitude of the crime committed against CHAMPVA and Medicare,\u201d said Acting Special Agent in Charge Molly King of the Department of Veterans Affairs Office of Inspector General\u2019s Northwest Field Office.\u0026nbsp; \u201cThe VA OIG\u2019s continued oversight of VA\u2019s multiple healthcare programs is one of the agency\u2019s highest priorities. We thank our law enforcement partners for their efforts in this joint investigation.\u201d\u003C\/p\u003E\n\n\u003Cp\u003EThe following individual has been charged in the District of Montana:\u003C\/p\u003E\n\n\u003Cp\u003ERonald David Dean, 64, of Whitefish, Montana, a licensed physician, was charged by information with conspiracy to commit wire fraud in connection with a telemedicine scheme.\u0026nbsp; As alleged in the information, Dean was paid by a telemedicine company to sign orders for durable medical equipment that patients did not need.\u0026nbsp; Dean then fraudulently charged Medicare and other government health programs for telemedicine office visits that did not occur.\u0026nbsp; The telemedicine company also used Dean\u2019s information to prescribe unneeded and unnecessary covid tests to patients.\u0026nbsp; In total, Dean\u2019s order resulted in false billing to government health care programs of over $39 million.\u0026nbsp; The U.S. Attorney\u2019s Office for the District of Montana is prosecuting the case.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Ci\u003EA complaint, information, or indictment is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.\u003C\/i\u003E\u003C\/p\u003E\n\n\u003Cp\u003EXXX\u003C\/p\u003E","changed":"\u003Ctime datetime=\u00222024-06-27T16:41:07-04:00\u0022\u003E1719520867\u003C\/time\u003E\n","component":[{"uuid":"a0640475-6d76-4fcb-b891-c0de885bf3d3","name":"USAO - Montana"}],"created":"\u003Ctime datetime=\u00222024-06-27T16:24:58-04:00\u0022\u003E1719519898\u003C\/time\u003E\n","date":"1719489600","image":"","number":"24-167","teaser":"","title":"National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 Billion in False Claims","topic":[{"uuid":"cce5d791-6b0b-462d-9a42-768179164d43","name":"Healthcare Fraud"}],"url":"https:\/\/www.justice.gov\/usao-mt\/pr\/national-health-care-fraud-enforcement-action-results-193-defendants-charged-and-over","uuid":"54b99d1c-d2b2-4fa3-b4ef-5a8938f28f2b"},{"attachment":"","body":"\u003Cp\u003E\u003Cb\u003E\u003Ci\u003EThree Defendants Charged in the Western District of Oklahoma\u003C\/i\u003E\u003C\/b\u003E\u003C\/p\u003E\n\n\u003Cp\u003EOKLAHOMA CITY \u2013 U.S. Attorney Robert J. Troester has announced criminal charges against three defendants in connection with the \u003Ca href=\u0022https:\/\/www.justice.gov\/opa\/pr\/national-health-care-fraud-enforcement-action-results-193-defendants-charged-and-over-275-0\u0022\u003EJustice Department\u2019s 2024 National Health Care Fraud Enforcement Action\u003C\/a\u003E. Descriptions of each case involved in the enforcement action are available on the \u003Ca href=\u0022https:\/\/www.justice.gov\/criminal\/criminal-fraud\/health-care-fraud-unit\/2024-national-hcf-case-summaries\u0022\u003EDepartment\u2019s website here\u003C\/a\u003E.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cIt 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,\u201d said Attorney General Merrick B. Garland. \u201cThe Justice Department will bring to justice criminals who defraud Americans, steal from taxpayer-funded programs, and put people in danger for the sake of profits.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cWe must protect these federal programs which provide vital funding to our society\u2019s most vulnerable,\u201d said United States Attorney Robert J. Troester. \u201cToday\u2019s nationwide announcement is further proof of the Department of Justice\u2019s ongoing commitment to protect Americans from those who seek to exploit government programs for personal gain.\u201d\u0026nbsp;\u0026nbsp; \u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u201cWe will not tolerate fraud that preys on patients who need and deserve high quality health care,\u201d said the Honorable Christi A. Grimm, the Department of Health and Human Services Inspector General (HHS-OIG). \u201cThe hard work of the HHS-OIG team and our outstanding law enforcement partners makes today\u2019s action possible.\u0026nbsp; We must protect taxpayer dollars and keep Americans safe from harms to their health, privacy, and financial well-being.\u201d\u003C\/p\u003E\n\n\u003Cp\u003EThe charges are part of a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 193 defendants for their alleged participation in health care fraud and opioid abuse schemes that resulted in the submission of over $2.75 billion in alleged false billings. As part of this national initiative, the following individuals have been charged in the Western District of Oklahoma:\u003C\/p\u003E\n\n\u003Cul\u003E\n\u003Cli\u003E\u003Cb\u003EDr. Dustin York\u003C\/b\u003E, 39, and \u003Cb\u003EVincent Carter\u003C\/b\u003E, 39, both of Oklahoma City, Oklahoma, were charged by indictment with health care fraud and conspiracy to pay kickbacks in connection with the delivery of DME. According to the indictment, York, a licensed chiropractor, and Carter, his business partner, operated Discover DME, a DME supplier. Through Discover DME, York and Carter are alleged to have purchased doctors\u2019 orders, paid kickbacks to obtain referrals through telemarketing companies, and then submitted false and fraudulent claims to Medicare based on those doctors\u2019 orders and referrals. In total, the defendants caused Discover DME to submit to a federal health care program false and fraudulent claims for DME totaling over $4.8 million. Discover DME was paid over $1.1 million as a result of the false and fraudulent claims. The case is being prosecuted by Assistant U.S. Attorneys Thomas Snyder and D.H. Dilbeck of the U.S. Attorney\u2019s Office for the Western District of Oklahoma.\u003C\/li\u003E\n\u003C\/ul\u003E\n\n\u003Cul\u003E\n\u003Cli\u003E\u003Cb\u003EPriscilla Orange\u003C\/b\u003E, age 66, of Oklahoma City, Oklahoma, was charged by indictment with obstruction of a federal audit, federal program theft, and making false statements to the Small Business Administration. As alleged in the indictment Orange operated a daycare provider in Oklahoma City that primarily served low-income children. Orange applied on behalf of her business for federal funds from programs administered by the Departments of Agriculture and Health and Human Services, as well as the Small Business Administration, and received approximately $494,000, but she subsequently misspent the money on impermissible personal expenses. The indictment further alleges that Orange obstructed a federal audit of her use of certain of the funds. The case is being prosecuted by Assistant U.S. Attorney D.H. Dilbeck of the U.S. Attorney\u2019s Office for the Western District of Oklahoma.\u003C\/li\u003E\n\u003C\/ul\u003E\n\n\u003Cp\u003ENOTE:\u0026nbsp; \u003Ci\u003EA complaint, information, or indictment is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.\u003C\/i\u003E\u003C\/p\u003E\n\n\u003Cp\u003EThe Western District of Oklahoma cases are the result of investigations by the Department of Health and Human Services Office of Inspector General, the Federal Bureau of Investigation, the U.S. Department of Veterans Affairs Office of Inspector General, and the United States Department of Agriculture Office of Inspector General.\u003C\/p\u003E","changed":"\u003Ctime datetime=\u00222024-06-28T10:09:12-04:00\u0022\u003E1719583752\u003C\/time\u003E\n","component":[{"uuid":"d6be3941-8347-4608-805f-23c4b4fd7d28","name":"USAO - Oklahoma, Western"}],"created":"\u003Ctime datetime=\u00222024-06-28T10:04:02-04:00\u0022\u003E1719583442\u003C\/time\u003E\n","date":"1719576000","image":"","number":"","teaser":"","title":"National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 Billion in False Claims","topic":[{"uuid":"cce5d791-6b0b-462d-9a42-768179164d43","name":"Healthcare Fraud"}],"url":"https:\/\/www.justice.gov\/usao-wdok\/pr\/national-health-care-fraud-enforcement-action-results-193-defendants-charged-and-over","uuid":"d800cdb1-7d10-48b4-89b1-71bfdf9edb7b"},{"attachment":"","body":"\u003Cp\u003EToday, Assistant U.S. Attorney Matthew Yelovich, Deputy Chief of the Criminal Division of the U.S. Attorney\u2019s Office for the Northern District of California, announced criminal charges against four defendants in connection with an alleged scheme to defraud federal health care benefit programs including Medicare and Medicaid. The charges filed in federal court are part of the Department of Justice\u2019s 2024 National Health Care Fraud Enforcement Action. The charges stem from an alleged conspiracy to provide prescriptions for Adderall and other stimulants to customers of an online health care service without a legitimate medical purpose for doing so. According to the several informations and the indictment filed against the defendants, they each had a role in enabling members of an online telehealth company to obtain Adderall and other stimulants from pharmacies by illegitimate means including making false and fraudulent representations to pharmacies, seeking to obstruct efforts by pharmacies to exercise their corresponding responsibility, and causing pharmacies to submit false and fraudulent claims for reimbursement to health care insurance plans.\u003C\/p\u003E\n\n\u003Cp\u003E\u201cIt 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,\u201d said Attorney General Merrick B. Garland. \u201cThe Justice Department will bring to justice criminals who defraud Americans, steal from taxpayer-funded programs, and put people in danger for the sake of profits.\u201d\u003C\/p\u003E\n\n\u003Cp\u003E\u201cWe allege that each defendant played a role in a scheme to submit fraudulent requests to Medicare and Medicaid to obtain reimbursements for drugs that were improperly prescribed through online services,\u201d said Deputy Chief Yelovich. \u201cMaking controlled substances available to persons without a legitimate medical purpose is drug dealing and knowingly facilitating bogus reimbursements from federal programs is fraud. This office will vigorously prosecute both.\u201d\u003C\/p\u003E\n\n\u003Cp\u003EThe charges announced today by Deputy Chief Yelovich are part of a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 193 defendants for their alleged participation in health care fraud and opioid abuse schemes that resulted in the submission of over $2.75 billion in alleged false billings. The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets, and the Government, in connection with the enforcement action, seized over $231 million in cash, luxury vehicles, gold, and other assets.\u003C\/p\u003E\n\n\u003Cp\u003EThe Health Care Fraud Unit\u2019s National Rapid Response, Florida, Gulf Coast, Los Angeles, Midwest, Northeast, and Texas Strike Forces; U.S. Attorneys\u2019 Offices for the Southern District of Alabama, District of Arizona, Central District of California, Northern District of California, Southern District of California, District of Connecticut, Middle District of Florida, Southern District of Florida, Northern District of Illinois, Eastern District of Kentucky, Western District to Kentucky, Eastern District of Louisiana, Middle District of Louisiana, Western District of Louisiana, Eastern District of Michigan, Western District of Michigan, Southern District of Mississippi, District of Montana, District of New Jersey, Eastern District of New York, Eastern District of North Carolina, Western District of Oklahoma, District of Rhode Island, Eastern District of Tennessee, Middle District of Tennessee, Eastern District of Texas, Northern District of Texas, Southern District of Texas, Eastern District of Virginia, Western District of Virginia, Southern District of West Virginia, and Eastern District of Wisconsin; and State Attorney Generals\u2019 Offices for Arizona, California, Illinois, Indiana, Louisiana, New York, Oklahoma, Pennsylvania, Puerto Rico, Rhode Island, and South Dakota are prosecuting the cases in the National Enforcement Action, with assistance from the Health Care Fraud Unit\u2019s Data Analytics Team. Descriptions of each case involved in today\u2019s enforcement action are available on the Department\u2019s website here.\u003C\/p\u003E\n\n\u003Cp\u003EThe Northern District of California, in particular, worked with the Department\u2019s Criminal Division and the following law enforcement organizations to investigate and prosecute the cases filed during the enforcement period: Drug Enforcement Administration, Homeland Security Investigations, the U.S. Department of Health and Human Services Office of Inspector General, and IRS Criminal Investigation.\u003C\/p\u003E\n\n\u003Cp\u003EThe following individuals are charged in the Northern District of California:\u003C\/p\u003E\n\n\u003Cp\u003E\u2022\u0026nbsp;\u0026nbsp; \u0026nbsp;Riley Levy, 30, of Peoria, Arizona, was charged by information with conspiracy to distribute controlled substances in connection with his role in an unlawful scheme to distribute Adderall and other stimulants. As alleged in the information, in the course and scope of his work for Done Health, P.C. and Done Global Inc. (\u201cDone\u201d), Levy, Done\u2019s Executive Leader, Operations and Strategy, conspired to distribute Adderall and other stimulants by means of the Internet that were not for a legitimate medical purpose in the usual course of professional practice. Health Care Fraud Unit Principal Assistant Deputy Chief Jacob Foster, Trial Attorney Raymond Beckering III of the National Rapid Response Strike Force, and Assistant U.S. Attorneys Kristina Green and Katherine Lloyd-Lovett of the U.S. Attorney\u2019s Office for the Northern District of California are prosecuting the case.\u003Cbr\u003E\n\u2022\u0026nbsp;\u0026nbsp; \u0026nbsp;Christopher Lucchese, 58, of Plano, Texas, was charged by information with conspiracy to defraud the United States and distribute controlled substances in connection with his role in an unlawful scheme to distribute Adderall and other stimulants. As alleged in the information, in the course and scope of his work for Done Health, P.C. and Done Global Inc., Lucchese, a medical doctor, issued prescriptions for Adderall and other stimulants that were not for a legitimate medical purpose in the usual course of professional practice. Health Care Fraud Unit Principal Assistant Chief Jacob Foster, Trial Attorney Raymond Beckering III of the National Rapid Response Strike Force, and Assistant U.S. Attorneys Kristina Green and Katherine Lloyd-Lovett of the U.S. Attorney\u2019s Office for the Northern District of California are prosecuting the case.\u003Cbr\u003E\n\u2022\u0026nbsp;\u0026nbsp; \u0026nbsp;Yina Cruz, 37, of Glenwood, New Jersey, was charged by information with conspiracy to defraud the United States and distribute controlled substances in connection with her role in an unlawful scheme to distribute Adderall and other stimulants. As alleged in the information, in the course and scope of her work for Done Health, P.C. and Done Global Inc., Cruz, a nurse practitioner, issued prescriptions for Adderall and other stimulants, including to Medicare and Medicaid beneficiaries, that were not for a legitimate medical purpose in the usual course of professional practice. Health Care Fraud Unit Principal Assistant Chief Jacob Foster, Trial Attorney Raymond Beckering III of the National Rapid Response Strike Force, and Assistant U.S. Attorneys Kristina Green and Katherine Lloyd-Lovett of the U.S. Attorney\u2019s Office for the Northern District of California are prosecuting the case.\u003Cbr\u003E\n\u2022\u0026nbsp;\u0026nbsp; \u0026nbsp;Katrina Pratcher, 70, of Altadena, California, was charged by information with conspiracy to defraud the United States and distribute controlled substances in connection with her role in an unlawful scheme to distribute Adderall and other stimulants. As alleged, in the course and scope of her work for Done Health, P.C. and Done Global Inc., Pratcher, a nurse practitioner, issued prescriptions for Adderall and other stimulants, including to Medicare and Medicaid beneficiaries, that were not for a legitimate medical purpose in the usual course of professional practice. Health Care Fraud Unit Principal Assistant Chief Jacob Foster, Trial Attorney Raymond Beckering III of the National Rapid Response Strike Force, and Assistant U.S. Attorneys Kristina Green and Katherine Lloyd-Lovett of the U.S. Attorney\u2019s Office for the Northern District of California are prosecuting the case.\u003C\/p\u003E\n\n\u003Cp\u003EA complaint, information, or indictment is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.\u0026nbsp;\u003C\/p\u003E","changed":"\u003Ctime datetime=\u00222024-07-01T13:02:33-04:00\u0022\u003E1719853353\u003C\/time\u003E\n","component":[{"uuid":"9562bf08-d474-4f10-a607-87ba645cee03","name":"USAO - California, Northern"}],"created":"\u003Ctime datetime=\u00222024-07-01T13:01:21-04:00\u0022\u003E1719853281\u003C\/time\u003E\n","date":"1719835200","image":"","number":"","teaser":"\u003Cp\u003EToday, Assistant U.S. Attorney Matthew Yelovich, Deputy Chief of the Criminal Division of the U.S. Attorney\u2019s Office for the Northern District of California, announced criminal charges against four defendants in connection with an alleged scheme to defraud federal health care benefit programs including Medicare and Medicaid. The charges filed in federal court are part of the Department of Justice\u2019s 2024 National Health Care Fraud Enforcement Action. The charges stem from an alleged conspiracy to provide prescriptions for Adderall and other stimulants to customers of an online health care service without a legitimate medical purpose for doing so. According to the several\u003C\/p\u003E","title":"National Health Care Fraud Enforcement Action Results in 193 Defendants Charged and Over $2.75 Billion in False Claims","topic":"","url":"https:\/\/www.justice.gov\/usao-ndca\/pr\/national-health-care-fraud-enforcement-action-results-193-defendants-charged-and-over","uuid":"0f2062d7-0bc5-41eb-aabf-8c85f6e7402b"},{"attachment":"","body":"\u003Cp\u003E\u003Cstrong\u003EDETROIT\u003C\/strong\u003E - Today, United States Attorney Jerome F. Gorgon, Jr. announced criminal charges and civil resolutions in three cases in connection with alleged schemes to unlawfully distribute controlled substances and defraud federal health care programs, including Medicare and Medicaid. The charges were filed in federal court and are part of the Department of Justice\u2019s 2025 National Health Care Fraud Enforcement Action. The criminal charges stem from the sale of controlled substance prescriptions in exchange for cash. The civil cases resolve alleged violations of the False Claims Act by several health care providers.\u003C\/p\u003E\u003Cp\u003E\u201cToday\u2019s record-setting Health Care Fraud Takedown sends a crystal-clear message to criminal actors, both foreign and domestic, intent on preying upon our most vulnerable citizens and stealing from hardworking American taxpayers: we will find you; we will prosecute you, and we will hold you accountable to the fullest extent of the law,\u201d said Attorney General Pamela Bondi. \u201cMake no mistake \u2013 this administration will not tolerate criminals who line their pockets with taxpayer dollars while endangering the health and safety of our communities.\u201d\u003C\/p\u003E\u003Cp\u003EAll the cases are part of a strategically coordinated, nationwide law enforcement action that resulted in criminal charges against 324 defendants for their alleged participation in health care fraud and illegal drug diversion schemes that involved the submission of over $14.6 billion in intended loss and over 15 million pills of illegally diverted controlled substances. The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets.\u0026nbsp; The United States has seized over $245 million in cash, luxury vehicles, and other assets in connection with the takedown.\u003C\/p\u003E\u003Cp\u003EThe criminal defendants charged in the Eastern District of Michigan were involved in a conspiracy to unlawfully distribute over 1.9 million commonly diverted controlled substance prescriptions for Oxycodone, Percocet, and Norco. The civil resolutions target $6 million in fraud on Medicare and Medicaid, returning much of those funds to the impacted federal programs.\u003C\/p\u003E\u003Cp\u003EThe Eastern District of Michigan, in particular, worked with the Department\u2019s Criminal Division, Civil Frauds, and the following law enforcement organizations to investigate, prosecute, and resolve the cases included as part of the Department\u2019s 2025 National Health Care Fraud Enforcement Action: the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) and FBI.\u003C\/p\u003E\u003Cp\u003EIn addition, the Fraud Section\u2019s Midwest Strike Force charged four defendants in the Eastern District of Michigan. In particular, law enforcement and prosecutors in the Eastern District of Michigan were involved in Operation Gold Rush, which targeted the attempt by foreign actors to steal more than $10 billion from the Medicare program. Click on the following link for more information about the charged cases:\u0026nbsp; \u003Ca href=\u0022https:\/\/www.justice.gov\/criminal\/criminal-fraud\/health-care-fraud-unit\/2025-national-hcf-case-summaries\u0022\u003Ehttps:\/\/www.justice.gov\/criminal\/criminal-fraud\/health-care-fraud-unit\/2025-national-hcf-case-summaries\u003C\/a\u003E\u003C\/p\u003E\u003Cp\u003EUnited States Attorney Gorgon said, \u201cWe are proud to partner with the Fraud Section Healthcare Fraud Strike Force to protect patients and preserve the integrity of our healthcare system. This collaboration strengthens our ability to identify and stop fraudulent activity so that resources are used to support care for Americans\u2014not exploitation. Healthcare fraud will not be tolerated.\u201d\u003C\/p\u003E\u003Cp\u003EThe U.S. Attorney\u2019s Office charged and resolved the following matters:\u003C\/p\u003E\u003Cp\u003EUsman Ahmad, R.Ph. 66 of Lake, Orion, Michigan; Durand Bynum, 46 of Canton, Michigan; Ebony Daniels, 33 of Eastpointe, Michigan; and Allen Satawhite, 37 of Detroit, were charged in a superseding indictment with conspiracy to possess with intent to distribute and to distribute controlled substances in connection with their roles in an unlawful scheme to distribute Schedule II controlled substances Oxycodone, Oxycodone-Acetaminophen (Percocet); and Hydrocodone-Acetaminophen (Norco). As alleged in the indictment, the owner of P \u0026amp; A Aftercare, located in Southfield, Michigan, hired several doctors to issue controlled substance prescriptions for a cadre of \u201cfake\u201d patients, without medical necessity and outside the scope of professional medical practice, in exchange for cash payments. The \u201cfake\u201d patients were recruited by Bynum, Daniels, Satawhite and others. Ahmad owned and operated Detroit Hoover Pharmacy, in Detroit, Michigan. He used the pharmacy to engage in a scheme and pattern of illegal conduct involving the unlawful distribution of prescription drug-controlled substances issued by the doctors at P \u0026amp; A Aftercare. Specifically, Ahmad distributed prescription drugs from the pharmacy illegally, outside the course of usual professional pharmacy practice and for no legitimate medical purpose. The case is being prosecuted by Assistant United States Attorneys for the Eastern District of Michigan Regina R. McCullough and Philip A. Ross.\u0026nbsp; \u0026nbsp;\u003C\/p\u003E\u003Cp\u003E\u0022The indictment of four individuals for their alleged roles in conspiracy to illegally distribute prescription drugs reflects the FBI\u0027s unyielding efforts to investigate and disrupt those who violate federal law,\u0022 said Cheyvoryea Gibson, Special Agent in Charge of the FBI in Michigan. \u0022Exploiting the well-being of our community and the healthcare system for personal gain will not be tolerated. The alleged actions betray public trust and divert critical resources. I also want to thank the members from our FBI Detroit Field Office and federal partners at the U.S. Department of Health and Human Services \u2013 Office of Inspector General for their continued work to uncover and dismantle these illegal schemes.\u0022\u003C\/p\u003E\u003Cp\u003E\u201cThe illegal prescribing and distribution of controlled substances\u2014particularly opioids\u2014by health care professionals puts the health and safety of our communities at serious risk,\u201d said Special Agent in Charge Mario M. Pinto of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). \u201cHHS-OIG will continue to collaborate closely with our law enforcement partners to investigate and prosecute these egregious allegations.\u201d\u003C\/p\u003E\u003Cp\u003EVilla Financial Services LLC, Villa Olympia Investment LLC, and six southeast Michigan Villa nursing homes \u2013 The Ambassador, Father Murray, Imperial, Regency, St. Joseph\u2019s and Westland \u2013 have agreed to pay the United States and the State of Michigan a total of $4,500,000, to resolve a civil qui tam lawsuit alleging that they violated the False Claims Act by systematically failing to provide services to nursing home residents and\/or providing materially and grossly substandard services to nursing home residents. Among other things, the United States alleged that the facilities failed to have a sufficient number of appropriately trained staff possessing satisfactory skill levels to adequately care for the residents. The United States also alleged that the facilities failed to take adequate measures to prevent, control, and provide care related to infections. In addition, the United States alleged that the facilities failed to take adequate measures to prevent and follow appropriate protocols related to resident falls. In connection with the settlement, Villa Financial Services LLC, Villa Olympia Investment LLC, and the six nursing homes will enter into a five-year quality-of-care Corporate Integrity Agreement (CIA) with HHS-OIG. Under the CIA, the settling companies are required to retain an independent quality monitor to review the companies\u2019 delivery of care and evaluate their ability to prevent, detect, and respond to patient care problems. The case is being jointly prosecuted by Assistant U.S. Attorney Leslie Wizner of the U.S. Attorney\u2019s Office for the Eastern District of Michigan and Trial Attorney Kelly McAuliffe of the U.S. Department of Justice\u2019s Commercial Litigation Branch - Fraud Section, in coordination with the Michigan Department of Attorney General\u2019s Health Care Fraud Division.\u003C\/p\u003E\u003Cp\u003EWahid Makki, 62, and his spouse, Zainab (aka Zeinab) Makki, 62, of Dearborn Heights, together with the two pharmacies they operated, Kirtland Corp. aka New Millennium Drugs and Western Wayne Pharmacy, LLC, have agreed to pay the United States and the State of Michigan $1,500,000 to resolve a civil qui tam lawsuit alleging that they violated the False Claims Act by submitting false claims to the Medicare and Medicaid Programs for prescription drugs that New Millenium Drugs and Western Wayne Pharmacy billed to the Programs, but never dispensed. In addition, Wahid Makki has agreed to his exclusion from the Medicare, Medicaid, and all other federal health care programs for 10 years. The case is being prosecuted by Assistant U.S. Attorney Leslie Wizner of the U.S. Attorney\u2019s Office for the Eastern District of Michigan, in coordination with the Michigan Department of Attorney General\u2019s Health Care Fraud Division.\u003C\/p\u003E\u003Cp\u003EThe investigation, prosecution and resolution of these matters illustrates the government\u2019s emphasis on combating health care fraud. Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the U.S. Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).\u003C\/p\u003E\u003Cp\u003EA complaint, information, or indictment is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law. The claims resolved by the civil settlements are allegations only; there has been no determination of liability.\u003C\/p\u003E","changed":"\u003Ctime datetime=\u00222025-06-30T11:43:43-04:00\u0022\u003E1751298223\u003C\/time\u003E\n","component":[{"uuid":"b67ce1d4-10d6-4ea1-b582-444dec4e8c1e","name":"USAO - Michigan, Eastern"}],"created":"\u003Ctime datetime=\u00222025-06-30T11:39:37-04:00\u0022\u003E1751297977\u003C\/time\u003E\n","date":"1751284800","image":"","number":"","teaser":"","title":"National Health Care Fraud Enforcement Action Results in 324 Defendants Charged and Over $14.6 Billion in Intended Fraud Loss Charged","topic":[{"uuid":"d13d6b86-209f-460e-878e-b4dd44f9435f","name":"Prescription Drugs"},{"uuid":"cce5d791-6b0b-462d-9a42-768179164d43","name":"Healthcare Fraud"}],"url":"https:\/\/www.justice.gov\/usao-edmi\/pr\/national-health-care-fraud-enforcement-action-results-324-defendants-charged-and-over","uuid":"bc64b22a-2e9e-44c7-a9e4-04989225176b"},{"attachment":"","body":"\u003Cp\u003E\u003Cstrong\u003EDETROIT\u003C\/strong\u003E \u2013 Today, United States Attorney Jerome F. Gorgon, Jr. announced criminal charges and civil resolutions in connection with six cases involving alleged schemes to defraud health care programs, including Medicare and Medicaid. The charges were filed in federal court and are part of the Department of Justice\u2019s 2026 National Health Care Fraud Enforcement Action. The criminal charges stem from the fraudulent billing of Medicare and Medicaid. The civil cases resolve alleged violations of the False Claims Act by several health care providers.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EThe charges announced today by United States Attorney Jerome F. Gorgon, Jr., are part of a strategically coordinated, nationwide law enforcement action that resulted in charges against 455 defendants, including 90 doctors and other licensed medical professionals, for their alleged participation in health care fraud and opioid abuse schemes involving over $6.5 billion in false claims and significant patient harm, including death. Today\u2019s Takedown represents a new era in federal, state, and international cooperation to combat health care fraud: cases in 56 federal districts and 45 U.S. states and territories, with 50 state Medicaid Fraud Control Units participating, the most in Department history. In addition, unprecedented international cooperation over the two-week Takedown resulted in the apprehension and return to the United States of the following health care fraudsters: one defendant in Kyrenia in connection with an over $3.7 billion scheme; two defendants in Estonia in connection with a previously charged $10.6 billion scheme; and, in the Philippines, one of FBI\u2019s Most Wanted Fraudsters in connection with a previously-charged $1.2 billion telemedicine fraud scheme. The Takedown involves the cutting-edge use of data analytics to target the worst actors; the seizure of over $182 million in cash, luxury vehicles, jewelry, and other assets; and full-spectrum accountability for all criminal actors from doctor\u2019s offices to corporate boardrooms.\u0026nbsp; \u0026nbsp;\u003C\/p\u003E\u003Cp\u003EToday\u2019s coordinated enforcement action involves a whole-of-government approach, including:\u0026nbsp;\u003C\/p\u003E\u003Cp\u003E\u2022\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Actions by the Centers for Medicare and Medicaid Services (CMS) to suspend 1,079 providers and revoke billing privileges for 1,403 providers.\u003C\/p\u003E\u003Cp\u003E\u2022\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 48 Civil Monetary Payment settlements amounting to over $73 million, over 1,400 provider exclusions, and 25 actions by the U.S. Department of Health and Human Services, Office of Inspector General (\u201cHHS-OIG\u201d) under the Civil Monetary Penalties Law seeking more than $10 billion in payments to the Medicare Trust Fund from payments that CMS caught and suspended before the funds were paid to the fraudulent providers.\u003C\/p\u003E\u003Cp\u003E\u2022\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Civil charges against 13 defendants for $14.8 million in health care fraud schemes, as well as civil settlements with 31 defendants totaling $23 million.\u003C\/p\u003E\u003Cp\u003E\u2022\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; 928 administrative cases by the Drug Enforcement Administration (DEA) seeking the revocation of authority to handle and\/or prescribe controlled substances since October 1, 2025.\u003C\/p\u003E\u003Cp\u003E\u201cThese schemes represent a direct attack on the integrity of federally funded health care programs. Fraudulent billing, false claims, and the failure to return federal funds are unacceptable and a blatant abuse of programs meant to support the American public,\u201d said Jennifer Runyan, Special Agent in Charge of the FBI Detroit Field Office. \u201cWe will continue to hold accountable anyone who seeks to exploit Medicare, Medicaid, or any other taxpayer supported system.\u0022\u003C\/p\u003E\u003Cp\u003E\u201cSafeguarding the integrity of federal health care programs is central to our mission, and the results of this year\u2019s National Health Care Fraud Takedown reflect the strength of our collective commitment. The cases announced today demonstrate not only the scale, but the seriousness of the misconduct uncovered, ranging from patient harming schemes to multibillion dollar fraud operations,\u201d said Department of Health and Human Services Inspector General T. March Bell. \u201cHHS-OIG will continue to pursue those who engage in such conduct and hold them accountable. I am grateful for the tireless work of our special agents and for the partnership we share with our federal, state, and local law enforcement colleagues as we work together to protect patients and preserve public funds.\u201d\u003C\/p\u003E\u003Cp\u003EThe following individuals were charged in the Eastern District of Michigan:\u0026nbsp;\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EHasan \u201cLucas\u201d Seyhun\u003C\/strong\u003E, 45, of Miami, Florida, was charged by indictment with conspiracy to commit healthcare fraud and conspiracy to launder monetary instruments in connection with an alleged $566 million billing fraud related to Fast Lab Technologies. As alleged in the First Superseding Indictment, Seyhun, as Fast Lab\u2019s Chief Operating Officer, conspired with its CEO (previously charged defendant Cemhan \u201cJimmy\u201d Biricik) and Medical Director (previously charged defendant Dr. Martin Perlin) to submit health insurance claims for laboratory testing services related to Covid-19 tests that were either not rendered at all or not provided as represented. The First Superseding Indictment also charges Seyhun and Biricik with an additional conspiracy, to both conceal and subsequently launder the proceeds of the health care fraud scheme. The First Superseding Indictment includes significant forfeiture allegations, with specific allegations of property subject to forfeiture that include: a personal aircraft, six high-end vehicles, numerous bank accounts, miscellaneous jewelry and designer handbags, and a residence in Boca Raton, Florida. The case is being prosecuted by Assistant United States Attorneys Regina R. McCullough and Ryan A. Particka of the U.S. Attorney\u2019s Office for the Eastern District of Michigan.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EEmad Hamdan\u003C\/strong\u003E, 55, of Dearborn Heights, Michigan, and\u0026nbsp;\u003Cstrong\u003ERaeyfah Baiz\u003C\/strong\u003E, 41, of Canton, Michigan were charged by way of an information with conspiracy to commit health care fraud for a pharmacy shortage scheme that caused at least $1.9 million in loss to Medicare, Medicaid, and Blue Cross Blue Shield of Michigan. Rabih Hamdan, owner of Medex Pharmacy (Medex), created a scheme to submit false and fraudulent claims for prescriptions that were not medically necessary or not actually dispensed. In many instances, his pharmacy lacked the inventory to dispense these drugs but billed the health care insurers as though they were dispensed. As alleged in the charging documents, Emad Hamdan was one of the supervisors at Medex. He directed Baiz and others to submit false and fraudulent claims to Medicare, Medicaid, and Blue Cross Blue Shield on behalf of Medex. As alleged in the charging documents, Raeyfah Baiz was the pharmacist-in-charge, who maintained a national provider identifier for the purposes of submitting claims to Medicare, Medicare drug plan sponsors, Medicaid, Medicaid health plans, and BlueCross BlueShield. Baiz partnered with Rabih Hamdan and Emad Hamdan to submit false and fraudulent claims to Medicare, Medicaid, and Blue Cross Blue Shield on behalf of Medex. The case is being prosecuted by Assistant United States Attorney Jason Dorval Norwood of the U.S. Attorney\u2019s Office for the Eastern District of Michigan.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EChristopher Dzialo\u003C\/strong\u003E, 35, of Reno, Nevada (previously of Grosse Pointe Farms, Michigan) was charged by Indictment with mail fraud and healthcare fraud in connection with a scheme to submit false pharmacy and medical insurance claims for high-reimbursement drugs that were never prescribed and services that were never rendered. As alleged in the indictment, between June 2023 and July 2025, Dzialo submitted at least eight fraudulent Direct Member Reimbursements (DMR) to his own insurance provider, seeking repayment for alleged out of pocket expenses. These claims either were for prescriptions he never obtained or medical procedures he never received, with an alleged value of $158,514.39. The case is being prosecuted by Assistant United States Attorneys Ryan A. Particka and Aleksandrs K. Bomis of the U.S. Attorney\u2019s Office for the Eastern District of Michigan.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EReno Dandy\u003C\/strong\u003E, a\/k\/a\/ \u201cRJ\u201d,\u0026nbsp;28, of Eastpointe, Michigan; and \u003Cstrong\u003EFrancina Kirk\u003C\/strong\u003E, a\/k\/a\/ \u201cKeisha\u201d, 45, of Pontiac, Michigan were charged in a superseding indictment with conspiracy to possess with intent to distribute and to distribute controlled substances in connection with their roles in an unlawful scheme to distribute Schedule II and V controlled substances Oxycodone, Oxycodone-Acetaminophen (Percocet), Hydrocodone-Acetaminophen (Norco), Oxymorphone, and Promethazine with Codeine. As alleged in the indictment, medical clinics were organized and purported to operate at different locations in Southeast Michigan, including Grace Medical Clinic, PLLC (Grace). Grace was operated by Dandy and Kirk, and Dr. Chinoy was a prescriber at Grace.\u0026nbsp;Dandy, Kirk, and other co-conspirators coordinated opioid controlled substance prescribing to Grace \u201cpatients\u201d by, among other things, receiving \u201cpatient\u201d information, loading \u201cpatient\u201d information into Grace\u2019s electronic prescribing platform, collecting payments from \u201cpatients\u201d or patient recruiters\/marketers, and sending electronic and other payments to Dr. Chinoy. From in or around November 2023 to on or about March 5, 2024, Dr. Chinoy electronically issued opioid controlled substance prescriptions to Grace \u201cpatients\u201d without seeing, examining, or communicating with the \u201cpatients,\u201d and instead Dr. Chinoy did so as directed by and based on patient information provided by Dandy, Kirk, and co-conspirators. During the conspiracy more than 400,000 dosage units of Schedule II and Schedule V controlled substances were unlawfully prescribed, which carried an estimated wholesale street value of more than $7 million. The case is being prosecuted by Assistant United States Attorneys Sarah Youngblood and Regina R. McCullough of the U.S. Attorney\u2019s Office for the Eastern District of Michigan. The Eastern District of Michigan is one of the twelve districts included in the Opioid Fraud Abuse and Detection Unit, a Department of Justice initiative to combat the opioid epidemic.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EThe civil matters included in the Takedown included settlements with the following entities and individuals:\u0026nbsp;\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EMcLaren Health Care Corporation\u003C\/strong\u003E and related entities (McLaren) of Michigan, agreed to pay a total of $1.9 million to resolve a qui tam False Claims Act lawsuit. The settlement resolves allegations that McLaren failed to timely repay overpayments from federally funded healthcare programs during the period from January 1, 2016, through June 18, 2021. The matter was handled by Assistant United States Attorney John Postulka of the U.S. Attorney\u2019s Office for the Eastern District of Michigan.\u0026nbsp; \u0026nbsp;\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EJason Herzog\u003C\/strong\u003E, the former CEO of Avertest, LLC, d\/b\/a Averhealth, a nationwide drug testing company located in Glen Allen, Virginia, reached a civil settlement to pay $150,000 to resolve allegations that in his capacity as CEO of Averhealth, he violated the False Claims Act when he knowingly submitted, or caused the submission of, false claims for payment on behalf of Averhealth to the Michigan Department of Health and Human Services, and knowingly made false statements material to those claims, concerning improper positive oral fluid drug test results. The case was settled by Assistant U.S. Attorney Anthony Gentner of the U.S. Attorney\u2019s Office for the Eastern District of Michigan.\u003C\/p\u003E\u003Cp\u003EThe cases are being prosecuted by the Health Care Fraud Section\u2019s National Rapid Response, Florida, Gulf Coast, Los Angeles, Midwest, New England, Northeast, Texas, and West Coast Strike Forces; U.S. Attorneys\u2019 Offices for the District of Arizona, Central District of California, Eastern District of California, Northern District of California, Southern District of California, District of Colorado, District of Connecticut, District of Delaware, Middle District of Florida, Northern District of Florida, Southern District of Florida, Northern District of Georgia, District of Idaho, Northern District of Illinois, District of Iowa, Western District of Kentucky, Eastern District of Louisiana, Middle District of Louisiana, District of Massachusetts, Eastern District of Michigan, Western District of Michigan, Southern District of Mississippi, District of Montana, District of Nevada, District of New Hampshire, District of New Jersey, District of Nex Mexico, Eastern District of New York, Northern District of New York, Southern District of New York, Western District of New York, Eastern District of North Carolina, Middle District of North Carolina, Western District of North Carolina, Northern District of Ohio, Southern District of Ohio, Northern District of Oklahoma, Western District of Oklahoma, District of Oregon, Eastern District of Pennsylvania, Western District of Pennsylvania, District of Rhode Island, District of South Carolina, District of South Dakota, Middle District of Tennessee, Western District of Tennessee, Northern District of Texas, Southern District of Texas, Western District of Texas, Eastern District of Virginia, Northern District of West Virginia, Southern District of West Virginia, Eastern District of Wisconsin, and Western District of Wisconsin; and State Attorneys General\u2019s Offices in Alaska, Arizona, Colorado, Connecticut, Florida, Georgia, Hawaii, Idaho, Illinois, Inidiana, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, and Wisconsin.\u003C\/p\u003E\u003Cp\u003EDescriptions of each case involved in today\u2019s enforcement action are available on the Department\u2019s website\u0026nbsp;\u003Ca href=\u0022https:\/\/justice.gov\/criminal\/criminal-fraud\/health-care-fraud-unit\/2026-national-hcf-case-summaries\u0022\u003Ehere\u003C\/a\u003E.\u003C\/p\u003E\u003Cp\u003EThe Eastern District of Michigan, in particular, worked with the Department\u2019s Health Care Fraud Unit of the Fraud Division and the following law enforcement agencies to investigate and prosecute the cases filed during the Takedown: the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) and the FBI.\u003C\/p\u003E\u003Cp\u003E\u003Cem\u003EAn indictment, information, or complaint is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.\u003C\/em\u003E\u003C\/p\u003E\u003Cp\u003E\u0026nbsp;\u003C\/p\u003E","changed":"\u003Ctime datetime=\u00222026-06-23T17:25:23-04:00\u0022\u003E1782249923\u003C\/time\u003E\n","component":[{"uuid":"b67ce1d4-10d6-4ea1-b582-444dec4e8c1e","name":"USAO - Michigan, Eastern"}],"created":"\u003Ctime datetime=\u00222026-06-23T15:20:29-04:00\u0022\u003E1782242429\u003C\/time\u003E\n","date":"1782216000","image":"","number":"","teaser":"","title":"National Health Care Fraud Enforcement Action Results in 455 Defendants Charged and Over $6.5 Billion in Intended Fraud Loss Charged","topic":[{"uuid":"cce5d791-6b0b-462d-9a42-768179164d43","name":"Healthcare Fraud"}],"url":"https:\/\/www.justice.gov\/usao-edmi\/pr\/national-health-care-fraud-enforcement-action-results-455-defendants-charged-and-over","uuid":"f0ded5dd-c07d-462c-b581-71f90a2a7b99"}]}