Healthcare Fraud and Opioid Takedown: What if You Were Targeted?

Healthcare Fraud and Opioid Takedown

345 Defendants Charged in 51 Federal Districts for More than $6 Billion in Alleged Fraud Losses

“This nationwide enforcement operation is historic in both its size and scope, alleging billions of dollars in healthcare fraud across the country,” said Acting Attorney General Brian C. Rabbitt. The U.S. Department of Justice recently announced in connection with this takedown, the creation of the National Rapid Response Strike Force targeting health care fraud. For detailed information on the takedown, read the DOJ’s press release, National Health Care Fraud, and Opioid Takedown Results in Charges Against 345 Defendants Responsible for More than $6 Billion in Alleged Fraud Losses.

Telemedicine fraud was a target in this takedown and it is alleged that more than 86 criminal defendants were charged for $4.5 billion in false and fraudulent reimbursement claims. The allegations state that doctors and nurses were paid for unnecessary equipment, testing, medications, and services for telemedicine patients who were never seen or met.  

More than a dozen defendants were charged in “sober homes” fraud cases. Allegations state that false and fraudulent claims totaling more than $845 million involved tests and treatments for patients seeking rehabilitation for alcohol and drug addiction.

Illegal prescriptions, distribution of opioids, and cases involving traditional healthcare fraud schemes involve more than 240 defendants and more than $800 million in fraudulent claims for services that were not medically necessary, and others billed but never provided. These fraud schemes involved multiple co-conspirators and kickbacks.

Michael V. Favia, IDFPR Attorney in Chicago, Recommends Doctors, Nurses, Dentists, and Other Healthcare Professionals Remain Vigilant in Preventing Healthcare Fraud

What we do not know from the DOJ’s report on this takedown, is how many people investigated, connected, or charged, had personal knowledge of these schemes. In many cases, some actors within these healthcare organizations made money committing fraud and exposed many other healthcare professionals to criminal and regulatory liability.

How Michael V. Favia & Associates Can Help You Insulate from Exposure to Healthcare Fraud Liability

When you call the Favia Law Firm, you can learn your exposure to liability for fraud claims. As you are likely aware, the weakest link in the chain can damage your practice, your license, and your career. Even though we may be able to successfully assist you with licensing and regulatory issues, we suspect you would do everything in your power to never have to face an investigation or worse.

In our licensing defense practice, too often we hear from healthcare professionals who handled IDFPR issues on their own, which could lead to unforeseen future complications. Michael V. Favia is a former Department Chief Prosecutor and he leverages his skills and experience as a former prosecutor to advise and represent doctors, nurses, dentists, and other licensed healthcare professionals in Illinois.

When you adopt routine audits and fraud protection plans in your practice, you get a better handle on all your records and practices. You may be better able to defend yourself if someday you are targeted.

Fraudulent Claims for Federal Healthcare Reimbursement, Telemedicine, and Sober Homes

Defendants charged in this takedown involve false and fraudulent claims involving telemedicine, substance abuse treatment, and other healthcare fraud and illegal opioid operations. The investigations into telemedicine, “sober homes,” and other traditional healthcare fraud schemes shows that law enforcement and investigation agencies are highly organized and effective in these takedowns.

Defendants charged with fraud claims in this takedown billed the government for illegitimate services and used aggressive marketing campaigns to lure patients, particularly those seeking opioids. We know from many investigations and reports that the opioid epidemic opens the door to countless forms of fraud. The amount of money made on bogus claims to Medicare, Medicaid, and other government and private entities is significant.

Doctors, Protect Yourself. Read Our Article: Insulating Your Healthcare Practice from Fraud Takedowns

Largest Alleged Fraud Takedown in History – $6 Billion

Here at Michael V. Favia & Associates, we have been reporting about nationwide investigations and task force takedowns for several years, including the article linked above with tips on insulating yourself and your healthcare practice in the event you are targeted in a fraud investigation. And last year we wrote, Major Opioid Bust: 60 Doctors and Pharmacists Charged.

Now, this huge takedown of 345 defendants in 51 Federal districts, shows us that local, state, and federal law enforcement and investigative agencies are dedicated and relentless. Several agencies work together in attacking the opioid epidemic and the frauds perpetrated against our government and other agencies.

Agencies Involved in Takedown:

  • U.S. Department of Justice, Criminal Division, Fraud Section;
  • U.S. Attorneys’ Offices;
  • U.S. Department of Health and Human Services – Office of the Inspector General;
  • U.S. Federal Bureau of Investigations;
  • U.S. Drug Enforcement Agency, Appalachian Regional Prescription Opioid Strike Force.

These fraud schemes cost U.S. taxpayers significant money and make people question the healthcare system generally.

Related: Listen to Chicago IDFPR Attorney Jacqueline Friedman-Stein talk about takedowns in our recent Favia Law Firm Podcast: Illinois Department of Financial and Professional Regulation (IDFPR) Updates and Trends.

Healthcare Fraud and Opioid Takedown Cases Are Serious and Your Chicago IDFPR Attorney, Michael V. Favia Can Help You Protect Your Practice, Your License, and Insulate You From Exposure to Fraud Scheme Liability (312) 609-6666 in Chicago in Rolling Meadows