Charges Levied Against 412 Individuals Responsible for $1.3 Billion in Fraud losses

In the largest fraud takedown in DOJ history, 412 individuals are being held responsible for $1.3 billion in false billing.

This article was originally published on July 20, 2017, on the Association of Clinical Documentation Improvement Specialists.

The Department of Justice (DOJ) and the Department of Health and Human Service Office of Inspector General announced on Thursday, July 13, charges against 412 individuals responsible for $1.3 billion in false billing. This fraud takedown is the largest in DOJ history, according to the department.

According to the court documents, “the defendants allegedly participated in schemes to submit claims to Medicare, Medicaid, and TRICARE for treatments that were medically unnecessary and often never provided,” the DOJ statement says.

Attorney General Jeff Sessions also highlighted that many of the fraud cases involved opioid claims in the DOJ statement.

The Trump administration signaled that it would make fighting health fraud a priority by significantly cutting funding to agencies like the National Institutes of Health and increasing funding to the Health Care Fraud and Abuse Control program in the budget proposal, according to Fierce Healthcare.

“Healthcare fraud is a reprehensible crime. It not only represents a theft from taxpayers who fund these vital programs, but it impacts the millions of Americans who rely on Medicare and Medicaid. In the worst fraud cases, greed overpowers care, putting patients’ health at risk,” said Inspector General Daniel Levinson in the DOJ statement.

Editor’s note: To read the entire DOJ statement, click here. To read Fierce Healthcare’s coverage of this story, click here.