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10 in west Kentucky charged with health fraud

10 in west Kentucky charged with health fraud

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

Charles Gerardi is accused of billing Medicare for unnecessary psychotherapy and billing for psychotherapy when he was actually performing medication management.

One set of charges in Florida details what prosecutors described as $106 million in fraudulent claims for substance abuse treatment in a scheme that involved "widespread fraudulent urine testing".

The Centers for Medicare and Medicaid Services has recently attempted to cap the vast majority of opioid doses at 90 morphine milligram equivalents, but an increasingly vocal advocacy network of chronic pain patients forced the agency to preserve much of the flexibility in its own rules.

"As alleged, the defendants charged throughout the Eastern District of NY as a part of the nationwide health care takedown abused their positions to enrich themselves, while bilking Medicare and Medicaid", U.S. prosecutor Richard P. Donoghue said.

In "many" cases, the DOJ said, patient recruiters, beneficiaries and other co-conspirators were allegedly paid cash kickbacks in return for supplying beneficiary information to providers, so the providers could submit fraudulent bills to Medicare. About $858,000 was paid out in fraudulent proceeds as a result, he said.

He also assigned a dozen prosecutors to focus exclusively on investigating and prosecuting opioid-related healthcare fraud in districts in need.

They were among 13 people, including five doctors, a chiropractor, three licensed physical and occupational therapists and two pharmacy owners charged with Medicare and Medicaid fraud.

Dr. Daniel Capen, 68, of Manhattan Beach, an orthopedic surgeon who agreed to plead guilty to conspiracy and illegal kickback charges of $142 million. "Rooting out health care fraud is central to the well-being of both our citizens and the overall economy".

The takedown is considered to be one of the largest health care fraud busts in U.S history.

According to court documents, Global hired sales representatives who were located in various states and were responsible for generating prescriptions from physicians and other prescribers.

Kentucky has been hit by one of the nation's highest overdose death rates, a crisis fueled by a surge of opioid-based drug abuse including prescription painkillers, heroin and fentanyl.

The Medicare Fraud Strike Force operations are part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.

Another defendant is accused of running a "false-front" pharmacy in which the identities of patients and doctors were stolen to bill for prescriptions that patients never received, he said.

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