42 medical professionals among those charged in alleged $1.4B healthcare fraud

The Justice Department criminally charged 138 people, including 42 medical professionals, for their alleged participation in healthcare schemes involving about $1.4 billion in fraudulent billings.

The charges, announced Sept. 17, target about $1.1 billion in alleged fraud committed using telemedicine, $29 million involving alleged COVID-19 healthcare fraud, $133 million connected to substance abuse treatment facilities and $160 million in other alleged healthcare fraud and illegal opioid distribution schemes.

The Justice Department said it is charging 43 criminal defendants across 11 jurisdictions with telemedicine fraud schemes. Prosecutors claim that physicians and nurse practitioners ordered unnecessary equipment or medication for patients without interacting with them or only having a brief call with patients they had never met or seen. 

Nine defendants were charged with allegedly engaging in healthcare fraud schemes "designed to exploit the COVID-19 pandemic." The Justice Department accused them of exploiting Medicare's leniency during the public health emergency. 

The alleged fraud cases are being prosecuted by 31 U.S. attorneys' offices around the country.

"This nationwide enforcement action demonstrates that the Criminal Division is at the forefront of the fight against health care fraud and opioid abuse by prosecuting those who have exploited health care benefit programs and their patients for personal gain," said Kenneth Polite Jr., assistant attorney general of the Justice Department's Criminal Division. "The charges announced today send a clear deterrent message and should leave no doubt about the department's ongoing commitment to ensuring the safety of patients and the integrity of health care benefit programs, even amid a continued pandemic."

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