Gulf Coast Health Care Fraud Law Enforcement Action Results in Charges Against 33 Individuals
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division announced today an expansive health care fraud enforcement operation across the Gulf Coast, involving charges against a total of 11 individuals across four federal districts for their alleged involvement in various schemes to defraud Medicare, Medicaid and TRICARE and to obtain oxycodone and other controlled substances by fraud. The conduct allegedly resulted in more than $515 million in fraudulent billings. Those charged included physicians, licensed social workers, as well as other medical and business professionals. In addition, in the state of Louisiana, 22 defendants, including 19 certified mental and home health professionals, have been charged with defrauding Medicaid out of approximately $300,000. These cases were investigated by Louisiana’s Medicaid Fraud Control Unit (MFCU).
Today’s enforcement actions were led and coordinated by the Health Care Fraud Unit of the Criminal Division’s Fraud Section in conjunction with its Medicare Fraud Strike Force (MFSF) partners, a partnership among the Criminal Division, U.S. Attorney’s Offices, the FBI, the Drug Enforcement Administration (DEA), and U.S. Health and Human Services-Office of Inspector General (HHS-OIG). In addition, the operation includes the participation of IRS-Criminal Investigations (IRS-CI), Mississippi Bureau of Narcotics (MBN) and various other federal law enforcement agencies and state MFCUs.
The charges announced today aggressively target alleged schemes billing Medicare, Medicaid, TRICARE (a health insurance program for members and veterans of the armed forces and their families) and private insurance companies for medically unnecessary services, such as psychotherapy and other behavioral health services, and items, including durable medical equipment and compounded medications.
“Fraud against our nation’s vital federal health care programs amounts to theft from American taxpayers,” said Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division. “The Department of Justice, together with our law enforcement partners, will continue to investigate and prosecute aggressively those who bill these programs for medically unnecessary services, whether in the Gulf Coast or elsewhere in the United States.”
Read more: https://www.justice.gov/usao-sdms/pr/gulf-coast-health-care-fraud-law-enforcement-action-results-charges-against-33