The United States Department of Justice (DOJ) created the Criminal Division’s Health Care Fraud Strike Force Program, which led the 2020 National Health Care Fraud and Opioid Takedown operation. The Takedown operation charged more than 300 individuals with allegedly committing healthcare fraud and prescribing missions of opioids. The charged schemes total more than $6 billion dollars in criminal activity.
The DOJ filed criminal charges against more than 50 doctors, more than 20 healthcare company executives, and a total of more than 100 licensed medical professionals. More than $4.5 billion of the charged activities involve the use of telemedicine. If you are one of the medical professionals, telemedicine providers, or substance abuse treatment centers targeted by the DOJ, a Washington criminal defense attorney could help protect your legal rights.
The Telemedicine Aspect of the Take Down Charges
The use of telemedicine has increased during the last few years. During the COVID-19 quarantine, telemedicine became a medical lifeline for many Americans who were following stay-at-home guidelines and limiting their face-to-face interactions.
Even before the COVID-19 pandemic, people in isolated or rural areas with limited options for medical services found telemedicine a practical way to obtain routine medical services. Some people who cannot visit their healthcare provider for logistical and other reasons benefit from telemedicine programs.
The DOJ says that some alleged criminals exploited telemedicine to generate massive amounts of illegal medical bills. In a New Jersey federal court, a group of healthcare professionals stands accused of submitting more than $522 million in false and fraudulent genetic testing billing to Medicare through a telemedicine scheme that included patients in every state. Also, a doctor in Illinois faces charges of submitting $145 million in fraudulent genetic testing bills.
Substance Abuse Treatment Centers
Both inpatient and outpatient treatment centers for substance abuse and addiction got caught up in the 2020 National Health Care Fraud and Opioid Takedown. In one county in Florida, the DOJ charged 10 defendants with a $91 million fraud scheme at inpatient and outpatient addiction treatment centers in that county. Three doctors, two clinic owners, and a CEO are some of the defendants in that case.
The DOJ is going after not only doctors and clinics for allegedly submitting bills to Medicare and insurance companies for unnecessary testing or services that patients did not receive or need. The DOJ expanded its net to charge laboratory owners with participating in fraud schemes. These criminal charges allege that, in one case, the doctors and lab owners worked together to prescribe and distribute more than 27 million doses of opioid drugs at a cost of over $40 million.
Some of the sanctions include the revocation of billing privileges with Medicare and Medicaid for more than 250 healthcare providers. The individuals and businesses accused of telemedicine fraud and other illegal activity also face the possibility of prison sentences and hefty fines. Medical professionals could lose their licenses to practice medicine and have their reputations destroyed.
A Washington criminal defense attorney could help if you get caught up in this or a similar takedown operation. Contact us today.
DISCLAIMER: This post is intended to share my perspective, insights, and some general information on criminal law matters. It is not legal advice and is not intended to substitute for legal advice. You should consult an attorney to obtain legal advice for your individual situation and case.