U.S. charges 601 people in major health care fraud takedown

U.S. Attorney General Jeff Sessions and Secretary of Health and Human Services Alex Azar arrive for a news conference to announce a nation-wide health care fraud and opioid enforcement action at the Justice Department in Washington U.S. Ju

U.S. Attorney General Jeff Sessions and Secretary of Health and Human Services Alex Azar arrive for a news conference to announce a nation-wide health care fraud and opioid enforcement action at the Justice Department in Washington U.S. Ju

"Some of our most trusted medical professionals look at their patients - vulnerable people suffering from addiction - and they see dollar signs", Attorney General Jeff Sessions said Thursday.

In the Southern District of Florida, 124 people were charged with offenses relating to their participation in various fraud schemes involving more than $337 million in false billings for services including home health care and pharmacy fraud. The 601 defendants include 165 doctors, nurses and other licensed medical professionals.

Sessions went on to say 162 people were charged, specifically in regard to opioid distribution.

More than 42,000 Americans died from opioid overdoses in 2016, according to the latest numbers from the U.S. Centers for Disease Control and Prevention.

Prosecutors said former hospital owner Michael Drobot spearheaded the scheme, which involved more than $40 million in illegal kickbacks paid to doctors and medical professionals over 15 years in return for referring thousands of patients who received surgeries and other services. These are despicable crimes.

Thomas Carpenter, who was medical director at Foundational Health, a Tampa area clinic, and Caridad Limberg-Gonzalez, who owned the clinic, are charged with conspiracy to commit health care fraud and wire fraud, four counts of health care fraud and three counts of making false statements.

That data, HHS Deputy Inspector General Gary Cantrell said, had enabled the agency to identify 300 prescribers "whose questionable opioid prescribing is worthy of further investigation".

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With the new cases being filed in "Spinal Cap", the fraudulent claims related to this scheme now span a 15-year period and total more than $950 million, prosecutors said.

Keep in mind the federal task force responsible for the takedown is focused on Medicare and Medicaid fraud specifically, but it cooperates with the private payer community regularly to chase down bad operators.

In the Global Compounding Pharmacy case in north Alabama, the defendants are charged with taking part in a multi-faceted, multi-million dollar scheme to defraud multiple insurance plans and their third-party pharmacy benefit managers by billing for fraudulent, often high-dollar prescriptions that Global would fill and bill for reimbursement. Crosby is accused of paying an alleged co-conspirator to recruit patients by promising them cash or other inducements, and Crosby allegedly billed for services not rendered, they said.

Omar Zoobi, a pharmacist and co-owner of Metro Pharmacy and Metro Rx Pharmacy LLC, and Gregory Sikorski, a physician's assistant: are included in a 10-count indictment charging each with one count of conspiracy to commit health care fraud and wire fraud, four counts of health care fraud, and one count of conspiracy to defraud the US and pay and receive health care kickbacks.

Erving Rodriguez: charged with one count of conspiracy to solicit and receive health care kickbacks.

A complaint, information, or indictment is merely an allegation, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.

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