On July 13, 2017, Attorney General Jeff Sessions and the Department of Health and Human Services (HHS) Secretary Tom Price, M.D., announced the eighth year of the federal health care fraud takedown. This year, the federal government’s main target was the nation’s rising opioid epidemic. In connection with the announcement, the Office of the Inspector General (OIG) released a report regarding opioid waste, fraud and abuse in the federal health care programs. The federal crackdown focuses primarily on opioid treatment centers that are alleged to have submitted false or fraudulent claim to health insurers.
Attorney General Sessions’ press conference described this joint effort with HHS OIG as “the largest health care fraud takedown in history.” The Medicare Fraud Strike Force charged 412 defendants across 41 federal districts with defrauding the federal government of a total of $1.3 billion. The defendants include 115 licensed health care professionals who are alleged to have participated in various health care fraud schemes. Thirty state Medicaid Fraud Control Units also participated in the arrests. In addition, HHS served exclusion notices on 295 health care providers for opioid diversion and abuse. Among those issued exclusion notices were 57 doctors, 162 nurses and 36 pharmacists.
According to Attorney General Sessions, today’s arrests are just the beginning of efforts and charges will continue to be brought in an effort to curb the growing opioid epidemic. In addition to the Strike Force, the enforcement actions include investigations and cases brought by 31 U.S. Attorney’s Offices. In the Southern District of Ohio, five defendants, including four physicians, were charged in connection with schemes involving $12 million in claims to the Medicaid program. Search warrants have also been issued to health care providers after investigation by the Northern District of Ohio.
Dinsmore & Shohl’s Health Care Practice Group will continue to keep its health care clients apprised of developments.