Feds charge 601 suspects in biggest healthcare fraud raid to date

U.S. Attorney General Jeff Sessions addresses a news conference to announce a nation-wide health care fraud and opioid enforcement action at the Justice Department in Washington

U.S. Attorney General Jeff Sessions addresses a news conference to announce a nation-wide health care fraud and opioid enforcement action at the Justice Department in Washington

The action, led by the Criminal Fraud Section of the Department of Justice, includes charges against 601 individuals, including charges against 156 doctors, nurses and other licensed medical professionals. "Our office will aggressively fight health care fraud and prosecute those individuals who contribute to the opioid epidemic".

According to the U.S. Centers for Disease Control and Prevention, 42,000 people in the U.S. died from opioid overdoses in 2016.

Those charged included a Florida anesthesiologist accused of running a "pill mill;" a Pennsylvania doctor alleged to have billed an insurer for illegally prescribed opioids; and a Texas pharmacy chain owner and two other people accused of improperly filling orders for opioids that were sold to drug couriers.

Ashraf Badr, a pharmacist and co-owner of Metro Pharmacy and Metro Rx Pharmacy LLC: charged with one count of conspiracy to commit health care fraud stemming from his role in a scheme whereby Badr and a co-conspirator paid a physician's assistant kickbacks in return for prescribing medically unnecessary compounded creams that were billed to Medicare. Kitco Metals Inc. and the author of this article do not accept culpability for losses and/ or damages arising from the use of this publication.

"Health care fraud schemes cost Americans billions of dollars every year through higher premiums and tax money stolen from public programs, such as Medicare", First Assistant U.S. Attorney Tracy L. Wilkison said.

Nationwide, 165 nurses and other licensed medical professionals were arrested in connection with false billings that total more than $2 billion.


"In many cases, doctors, nurses and pharmacists take advantage of people suffering from drug addiction in order to line their pockets", Sessions stated. These are despicable crimes.

According to court documents, defendants from the national sweep allegedly participated in schemes to submit claims to Medicare, Medicaid and TRICARE for treatments that were medically unnecessary and often never provided. Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3,700 defendants who, collectively, have falsely billed the Medicare program for more than $14 billion.

"It takes a special kind of person to prey on the sick and vulnerable as happened in many of these health care fraud schemes", said Deputy Chief of IRS Criminal Investigation Eric Hylton.

Ashlee McFarlane, former federal prosecutor and partner at Gerger Khalil & Hennessy, told Healthcare Dive via email that the takedown shows DOJ "is committing significant resources to criminally prosecuting anyone who prescribes drugs or distributes opioid prescriptions outside the normal course of medical practice".

The indictment charges Irena Shut, 41, an attorney who lives in Hidden Hills, with paying kickbacks to two podiatrists to authorize prescriptions written on pre-printed prescription pads created to maximize insurance payments, regardless of the medical need for an expensive compounded formulary for each "patient".

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