US Justice Dept cracks down on healthcare fraud schemes linked to $2.75bn loss

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来源: Pharmaceutical Technology

General Merrick Garland announcing the results of a nationwide healthcare fraud investigation at a 27 June press conference at the US Department of Justice. Credit: Samuel Corum via Shutterstock.

The US Justice Department has charged 193 people in a major enforcement action, accusing them of participating in healthcare fraud schemes worth $2.75bn.

The two-week crackdown involved 76 doctors, nurses, and other medical professionals. The defendants are accused of several scams, such as illegally distributing millions of Adderall (amphetamine) pills and other stimulants. This also included fraudulent activity that involved corporate executives distributing tainted and misbranded HIV medication, which amounted to $90m in losses.

Ruthia He, founder and CEO of San Francisco-based digital technology company Done Global, was arrested on 13 June. He has been charged with participating in a scheme to distribute Adderall (amphetamine / dextroamphetamine) over the internet and conspired to commit healthcare fraud in connection with the submission of fraudulent claims for reimbursement for the drug and other stimulants. Adderall is a drug used to treat attention deficit hyperactivity disorder (ADHD).

Also included in this crackdown were three executives of a pharmaceutical distributor who allegedly bought HIV medications through fraudulent schemes and resold them with falsified documents to pharmacies nationwide. This led to patients unknowingly receiving mislabelled drugs, one of whom fell unconscious for 24 hours after taking the wrong medication.

Attorney General Garland said in a statement: “It does not matter if you are a trafficker in a drug cartel or a corporate executive or medical professional employed by a healthcare company. If you profit from the unlawful distribution of controlled substances, you will be held accountable.”

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Other instances involve allegations against two owners of wound care firms who allegedly accepted over $330m in kickbacks in a scheme to fraudulently bill Medicare for amniotic wound grafts— biological dressings used to promote the healing of wounds. In Arizona, a woman is accused by prosecutors of improperly billing the state’s Medicaid agency for substance abuse treatment services that either lacked genuine benefit or were never actually administered.

The agency announced that they had also seized $230m in cash, luxury vehicles, gold, and other assets in connection with these cases, adding the schemes resulted in $1.6bn in losses.

“Through this action, we in federal law enforcement send a clear and strong message—that we will hold accountable those healthcare providers and prescribers who prey on their patients for profit and disregard the first rule of medical care: do no harm,” said US Secretary of Homeland Security Alejandro Mayorkas.

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