Health

DOJ charges dozens of health care fraud schemes, including $1.9 billion in bogus claims


WASHINGTON — The Justice Department has charged dozens of people in several health care and prescription drug fraud schemes, including a $1.9 billion scheme and a doctor accused of ordering splints. prosthetic ankle for a patient with a leg amputation, officials said Wednesday.

The agency said the scheme involved the filing of nearly $2 billion in bogus claims in one of the largest healthcare fraud cases ever launched by the Justice Department. It was one of many announced as part of a crackdown in states around the country.

In total, 78 people in 16 states have been charged in a series of separate cases, including conspiring to buy HIV drugs from patients and then resell them.

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The defendants targeted vulnerable people and used the money they earned to buy cars, jewelry and yachts, federal investigators said. The federal government has seized millions of dollars in cash, cars and real estate as part of the crackdown.

“The Department of Justice will find and bring to justice criminals who seek to defraud Americans and steal from taxpayer-funded programs,” Attorney General Merrick Garland said in a statement.

In a case filed in the Southern District of Florida, investigators say they found nearly $2 billion in fraudulent telemedicine claims submitted to government-funded insurance programs. benefits such as Medicare and Medicaid, which primarily cover people age 65 and older and low-income individuals, respectively. No attorneys were listed on Wednesday for the three men charged in connection with online platform DMERx, and a message left for the parent company was not immediately returned.

Investigators say these cases involved fake doctor orders for braces and pain creams used in exchange for kickbacks and bribes.

In another telemedicine scam, prosecutors say a Washington state doctor, David Antonio Becerril, signed more than 2,800 fraudulent orders, including an ankle brace for an amputated patient. feet many years ago. He is accused of taking less than 40 seconds to review and sign each order. One of his attorneys, William Portanova, declined to comment.

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In some cases, computer software generates fake physician orders and patients, said Omar Perez Aybar, special agent in charge of the Miami area office of the inspectors at the US Department of Health and Human Services. The patient never gets to see the doctor or has only a brief conversation with the doctor. overview.

“There are providers and patients all over the country,” he said.

In another case, a Brooklyn man allegedly worked with others to buy more than $150 million in prescription drugs, including HIV drugs, from vendors who had bought them back. from the patient. Steven Diamantstein is accused of re-labeling drugs for sale. His defense attorney, Zach Intrater, said Diamantstein has pleaded not guilty to the charges and “looks forward to arguing it in court.”

Perez Aybar said the investigation involved a number of agencies, including the FBI, the Drug Enforcement Administration and the state’s Medicaid fraud units.

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