Attorney General Merrick Garland announced Thursday a two-week operation in which 193 people across the country, including 76 licensed healthcare providers, were charged for their alleged participation in healthcare fraud schemes.
The 145 cases highlighted by the Department of Justice (DOJ) involved over $2.75 billion of intended losses and $1.6 billion in actual losses, Garland said. Among allegations highlighted by the DOJ were medically unnecessary amniotic wound grafts, diverted HIV medications, online distribution of Adderall and other telemedicine schemes.
“As healthcare fraud schemes continue to evolve, so will the Justice Department’s investigative and prosecutorial strategies,” Garland said during a Thursday press conference. “Our messages to those seeking to exploit patients and defraud government programs is clear: You cannot hide your crimes. We will find you, and we will hold you accountable.”
The Criminal Division’s Health Care Fraud Unit, Federal coordinated with a slew of state and other federal law enforcement agencies including the Drug Enforcement Administration, the FBI and the Department of Health and Human Services Office of Inspector General (HHS-OIG).
Together, the government said it was able to seize more than $231 million in “cash, luxury vehicles, gold and other assets” alongside the convictions across 32 federal districts and 11 states.
Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure also noted in a statement that her agency “took 127 administrative actions in the last six months separately against providers for their alleged involvement in healthcare fraud schemes.”
Top of law enforcement’s list was a $900 million-plus fraud scheme in which four defendants allegedly targeted elderly Medicare patients for pricey amniotic grafts. These treatments were applied to the patients’ superficial wounds “indiscriminately, without coordination with the patient’s treating physicians and without proper treatment for infection,” DOJ said in a statement. Two of those defendants received over $600 million from Medicare within just a 16-month period, DOJ said.
Other action detailed by the government involved three owners and executives of a wholesale drug distributor. Law enforcement charged these defendants with a $90 million wire fraud conspiracy over “adulterated and misbranded HIV drugs” they allegedly purchased back from patients and resold to pharmacies across the country.
“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,” the DOJ wrote of the scheme.
The government also highlighted previously announced charges against the CEO and clinical president of telehealth startup Done, which it said arranged the prescription of 40 million stimulant pills such as Adderall. The new announcement pointed to new charges against their co-conspirators, including a Florida nurse practitioner the DOJ said prescribed more than 1.5 million pills without any interaction with patients.
Done recently said in a statement that it “disagrees” with the charges against its leadership and plans to continue operations.
“Healthcare fraud victimizes patients, endangers the health of vulnerable people, and plunders healthcare programs,” FBI Director Christopher Wray said in a statement. “This wide-ranging collaboration demonstrates the FBI’s commitment to rooting out predatory healthcare fraud, protecting patients and ensuring critical healthcare funds go where they are needed most.”
Since its 2007 inception, the DOJ’s Health Care Fraud Strike Force has charged over 5,400 defendants who have billed public and private health insurers more than $27 billion.