Charges Laid Against 412 Individuals for Medicaid Fraud and Opioid Prescribing

July 13, 2017, 1:45PM. By Lucy Campbell

Santa Clara, CAThe US Attorney General’s office has charged 412 defendants in 41 federal districts with Medicaid fraud resulting from false billings, and prescribing and distributing opioids and other dangerous drugs. The fraud is estimated to have cost Medicaid $1.3 billion resulting from false billings. More than 120 defendants have been charged for their roles in prescribing and distributing opioids and other dangerous narcotics, including doctors. In addition, Health and Human Services has initiated suspension actions against 295 providers, including doctors, nurses and pharmacists.

According to a statement by the AG’s office, the charges target schemes billing Medicare, Medicaid, and TRICARE (a health insurance program for members and veterans of the armed forces and their families) for medically unnecessary prescription drugs and compounded medications that often were never even purchased or distributed.

Notably, 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. According to the Centers for Disease Control, approximately 91 Americans die every day of an opioid related overdose.

According to court documents cited in the Department of Justice press release, the defendants allegedly participated in schemes to submit claims to Medicare, Medicaid and TRICARE for treatments that were medically unnecessary and often never provided. In many cases, patient recruiters, beneficiaries and other co-conspirators were allegedly paid cash kickbacks in return for supplying beneficiary information to providers, so that the providers could then submit fraudulent bills to Medicare for services that were medically unnecessary or never performed.