Providers from 35 states charged in healthcare fraud crackdown: Here's the breakdown

The DOJ's national healthcare fraud takedown resulted in charges against more than 600 defendants, including 165 doctors, nurses and other licensed medical professionals. 

Here's the rundown on defendants charged in districts across the U.S.:

Alabama: Fifteen charged for their roles in eight healthcare fraud schemes involving compounding pharmacy fraud and unlawful distribution of controlled substances.

California: Thirty-three charged for involvement in schemes to defraud insurance programs out of more than $660 million. Four charged for involvement in two healthcare fraud schemes, one of which included forged prescriptions. Seven charged for roles in three healthcare fraud schemes and one scheme involving identity theft and services not performed.

Colorado: One defendant charged with healthcare fraud related to Medicaid and Medicare billings.

Connecticut: Three defendants charged in two schemes involving compounding drugs and unlawful distribution of Schedule II and IV controlled substances.

Delaware: Physician/owner of a pain management clinic charged with unlawfully prescribing more than two million doses of oxycodone products.

D.C.: A durable medical equipment company owner charged with defrauding Medicaid of $9.8 million.

Florida: Twenty-one charged for schemes involving more than $21 million in fraudulent billings. Four charged in a scheme to defraud TRICARE and other private insurance companies out of more than $8 million. An additional 124 charged with participation in fraud schemes involving over $337 million in false billings for services including home healthcare and pharmacy.

Georgia: Twelve defendants, including two physicians, charged in nine healthcare fraud, drug diversion or compounding pharmacy schemes involving more than $13.5 million in fraudulent billings.

Idaho: Three defendants, all of who are medical professionals, charged for their roles in three separate fraud schemes involving controlled substances.

Illinois: Twenty-one charged for various fraud schemes involving home health and dental services. Seven charged in six separate schemes to defraud the Medicaid program.

Indiana: Eight charged in healthcare fraud schemes to defraud Medicare and Medicaid.

Iowa: Two medical professionals charged for roles in two opioid-related schemes.

Kansas/Oklahoma: Twelve individuals, including four physicians, charged with unlawful distribution of controlled substances.

Kentucky: Twelve defendants, including five medical professionals, charged in schemes involving healthcare fraud, unlawful distribution of controlled substances, aggravated identity theft and money laundering. One case involved two false-front medical clinics.

Louisiana/Mississippi: Forty-two charged in connection with healthcare fraud, drug diversion and money laundering schemes involving more than $16 million in fraudulent billings.

Michigan: Thirty-five charged for alleged roles in fraud, kickback, money laundering and drug diversion schemes involving approximately $197 million in false claims for medically unnecessary services or ones never provided.

Maine/Vermont: Two charged for roles in two schemes to defraud Medicare, Medicaid and programs run by the HHS' Administration for Children and Families.

Nebraska: Seven defendants, including one physician, charged in five separate schemes to defraud Medicare, Medicaid and HHS programs.

Nevada: Four defendants, including three medical professionals, charged with conspiracies to commit healthcare fraud and distribute controlled substances.

New Jersey: Eight defendants — including a New York physician, an anesthesiology technologist for a Philadelphia hospital and the owner of a medical billing company — charged for roles in schemes to defraud private insurance companies of more than$16 million.

New York: Thirteen charged for involvement in schemes including kickbacks, services not rendered, identity theft and money laundering involving more than $38 million in fraudulent billings. Two defendants charged in schemes involving healthcare fraud or drug diversion.

North Carolina: Two charged with a conspiracy to defraud Medicare out of $4 million-plus.

Ohio: Three medical professionals charged for roles in two healthcare fraud schemes, one of which involved illegal drug distribution and kickbacks.

Pennsylvania: Twelve defendants charged for roles in three drug diversion schemes. Four physicians charged in healthcare fraud and drug diversion schemes, one of which involved 32,000 doses of buprenorphine.

Rhode Island: One charged for participating in a theft and aggravated identity theft scheme.

South Carolina: Three charged for roles in a conspiracy to possess with the intent to distribute fentanyl.

South Dakota: Two charged in separate cases, one of which involved a scheme to defraud the Indian Health Service.

Tennessee: Ten charged in two separate schemes, including a conspiracy to fraudulently obtain oxycodone. Five charged with a kickback conspiracy at a durable medical equipment company that allegedly resulted in more than $1 million in kickbacks and $2.5 million in false billings to Medicare.

Texas: Forty-eight charged in cases involving more than $291 million in alleged fraud. Two charged for roles in healthcare fraud schemes to defraud Medicare and Medicaid.

Utah: Two charged in two cases, one of which involved a $31 million scheme to defraud Medicare and Medicaid.

Virginia: Eight charged for alleged roles in healthcare fraud schemes.

Washington: One dentist and another individual indicted for distributing hydrocodone and tramadol without a legitimate medical purpose.

Wisconsin: Three charged in a scheme involving the unlawful distribution of controlled substances and aggravated identity theft.

In addition, 97 defendants from several states were charged with defrauding the Medicaid program out of more than $27 million. Those states are Arizona, Arkansas, California, Connecticut, Delaware, Florida, Hawaii, Illinois, Indiana, Kansas, Louisiana, Maine, Michigan, Missouri, Mississippi, Nevada, New York, Oklahoma, Pennsylvania, Texas, Vermont and Washington

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Articles We Think You'll Like

 

Featured Whitepapers

Featured Webinars