Published: Sun, July 01, 2018
Health Care | By Cedric Leonard

AG Sessions Announces 601 Charged Amid Largest Opioid Crackdown

AG Sessions Announces 601 Charged Amid Largest Opioid Crackdown

Already, Sessions said, enforcement has resulted in lower billing levels in some government health programs, with billings for Medicare Part A and Part B - which cover inpatient care and many physician-prescribed drugs, respectively - dropping by 20 percent in districts with fraud strike forces.

Of that staggering total, about 125 defendants were charged in South Florida with filing almost $340 million in fraudulent claims for opioid addiction treatment, home healthcare and prescription drugs covered by taxpayer-funded programs and other insurance plans.

According to the USA attorney general's office, 601 defendants were charged for alleged fraud totaling an estimated $2 billion. They include 76 doctors, 23 pharmacists, 19 nurses, and other medical workers.

They are being charged for their roles in prescribing and distributing addictive painkillers. The charges also involve individuals contributing to the opioid epidemic, with a particular focus on medical professionals involved in the unlawful distribution of opioids and other prescription narcotics, a particular focus for the Department.

Authorities said the nationwide schemes involved billing Medicare, Medicaid, and private insurance companies for medically unnecessary prescription drugs and other medications that were sometimes never purchased or distributed. These are despicable crimes.

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According to Coleman, law enforcement has also executed multiple search warrants over the past few weeks related to possible health care fraud and opiate overprescribing, including at a residence, an oncologist's practice and several pain clinics. That's why this Department of Justice has taken historic new steps to go after fraudsters, including hiring more prosecutors and leveraging the power of data analytics.

With the new cases being filed in "Spinal Cap", the fraudulent claims related to this scheme now span a 15-year period and total more than $950 million, prosecutors said. "By every measure we are more effective at finding and prosecuting medical fraud than ever". Officials said Ruiz operated a false-front pharmacy where he stole and used the identities of patients and doctors to bill for prescriptions that patients never received, resulting in approximately $858,000 being paid out in fraudulent proceeds.

Dr. Daniel Capen, 68, of Manhattan Beach, an orthopedic surgeon who agreed to plead guilty to conspiracy and illegal kickback charges of $142 million.

Dr. Yong Jun Kim, a medical doctor who operated My Health Wellness Center in Flushing, Queens, was charged with one count of conspiracy to commit health care fraud and one count of violating the anti kickback statute. "Texas Attorney General Ken Paxton is committed to continuing to work with our federal partners to uncover waste, fraud, and abuse in the Medicare and Medicaid systems", said Stormy Kelly, Division Chief within the Medicaid Fraud Control Unit of the Office of Texas Attorney General.

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