DOJ costs 138 with health-care fraud, together with opioids, Covid, telemedicine

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The Department of Justice on Friday announced criminal charges against 42 medical professionals and nearly 100 other people for alleged health-care fraud that involved about $1.4 billion in suspected losses.

The cases charged include ones that involved the use of telemedicine services as part of the fraud, which alone accounted for approximately $1.1 billion in alleged losses from false and fraudulent claims. Telemedicine employs communications technology to evaluate and treat patients remotely.

The telemedicine cases built on prosecutions launched in 2019 and 2020, which involved allegations of billing Medicare for fraudulent genetic cancer testing, and telemedicine executives paying doctors and others to order unnecessary durable medical equipment, diagnostic testing and medications, either without actually interacting with patients or having a brief call with ones they had never met or seen.

The other charged schemes announced Friday involved fraud that exploited the Covid-19 pandemic, or involved substance abuse treatment facilities known as “sober homes,” and opioid distribution networks.

“We are stopping corrupt medical professionals in their tracks,” Assistant Attorney General Kenneth Polite Jr. of the Justice Department’s criminal division told reporters during a briefing about the case.

The 138 people charged in the cases include 23 physicians, the DOJ said. The cases are being prosecuted by 31 U.S. attorneys’ offices around the country.

Polite noted that opioid-related overdoses killed a “record number of Americans, nearly 70,000,” last year, and that drug overdose deaths overall increased by more than 30%, with 90,000 people dead as a result in 2020.

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Nineteen people were charged in opioid-related fraud cases by the DOJ, 16 of whom were doctors or other medical professionals.

“Holding to account those responsible for health care fraud and diversion of prescription drugs is a priority for DEA,” said Anne Milgram, administrator of the Drug Enforcement Administration, in a statement.

“These fraudulent activities prey on our most vulnerable – those in pain, the substance-addicted, and even the homeless – those who are most susceptible to promises of relief, recovery, or a new start,” Milgram said.

“Not only do these schemes profit from desperation, but they often leave their victims even deeper in addiction.”

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