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DOJ: 78 charged over $2.5B in healthcare fraud schemes

U.S. Attorney General Merrick Garland said Wednesday that a $1.9 billion healthcare fraud schemes busted in a recent nationwide crackdown is one of the largest ever prosecuted. Pool File Photo by Sarah Silbiger/UPI
U.S. Attorney General Merrick Garland said Wednesday that a $1.9 billion healthcare fraud schemes busted in a recent nationwide crackdown is one of the largest ever prosecuted. Pool File Photo by Sarah Silbiger/UPI | License Photo

June 28 (UPI) -- The Justice Department said Wednesday that federal prosecutors have charged dozens of people in a nationwide crackdown on healthcare fraud that prosecutors said attempted to steal billions of dollars from elderly and disabled care programs.

Seventy-eight defendants, including doctors and other healthcare professionals, have been charged amid the two-week law enforcement operation for their roles in more than $2.5 billion in alleged fraud.

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Prosecutors said the ill-gotten proceeds purchased the defendants exotic cars, jewelry and yachts as well as other luxury goods, some of which the Justice Department was able to seize amid the operation along with millions of dollars in cash.

"These enforcement actions, including against one of the largest healthcare fraud schemes ever prosecuted by the Justice Department, represent our intensified efforts to combat fraud and prosecute the individuals who profit from it," Attorney General Merrick Garland said in a statement.

"The Justice Department will find and bring to justice criminals who seek to defraud Americans and steal from taxpayer-funded programs."

One of the schemes saw 11 people accused of submitting some $1.9 billion in false and fraudulent claims to Medicare and other government insurers in what prosecutors said is one of the largest healthcare fraud schemes ever prosecuted.

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According to the indictment, the telemedicine fraud conspiracy targeted the elderly and disabled with direct mail and television advertisements to induce them to call offshore boiler-rooms where telemarketers would try to up-sell them unnecessary orthotic braces, prescription skin creams and other such medical items.

Prosecutors said the defendants created a software platform that acted as a conduit for telemarketers to coordinate the payment of illegal kickbacks and bribes to telemedicine companies in exchange of doctors' orders for the Medicare beneficiaries.

The software platform allegedly generated false and fraudulent orders for the telemedicine practitioners to sign while making it appear as if the interactions with the patients occurred in person.

The orders falsified certifications that the telemedicine doctors had examined the patients in person while fabricating diagnostic testing needed to place Medicare orders for braces.

Another scheme saw charges brought against 10 defendants for the submission of more than $370 million in fraudulent claims for prescription drugs.

Court documents state that $150 million of that fraud involved a company having purchased illegally diverted prescription HIV medication that was then resold as if it had been legally acquired.

"Patients trust federal healthcare programs to provide high-quality care," Inspector General Christi Grimm of the Department of Health and Human Services Office of the Inspector General said in a statement.

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"When bad actors steal from these programs, they hurt patients."

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