DOJ charges 58 people in alleged Texas health care fraud

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DALLAS, Texas (KXAN) — The Justice Department announced Wednesday it has conducted a coordinated health care fraud enforcement operation in Texas in which 58 people face charges. Sixteen of those people are doctors or medical professionals and 20 were charged for their role in diverting opioids.

The takedown operation targeted billing schemes directed at health insurance programs like Medicare, Medicaid, TRICARE (a health insurance program for military personnel, veterans and their families), Department of Labor-Office of Worker’s Compensation Programs and private insurance companies. The charges allege that these health insurance programs were billed for medically unnecessary prescriptions and medications that were never purchased or distributed to patients. Charges also include individuals suspected of contributing to the opioid epidemic by unlawfully distributing opioids and other prescription narcotics.

The investigation and enforcement actions were coordinated by the Health Care Fraud Unit of the DOJ’s Criminal Division along with its Medicare Fraud Strike Force. They worked with multiple government departments including the Drug Enforcement Administration, U.S. Attorney’s Offices, FBI and Health and Human Services-Office of Inspector General. Other participating agencies include Texas State Medicaid Fraud Control Units, Veterans Affairs-OIG and the Department of Labor.

“Today’s charges highlight the amazing work being done by the Department’s Medicare Fraud Strike Force and our partners in Texas,” said Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division.  “As we continue to dedicate resources to battle healthcare and opioid fraud schemes in Texas and elsewhere, we are shining an inescapable light on dirty doctors, clinic owners, pharmacists, and others who may have long believed they could perpetrate their frauds behind closed doors.” 

According to the Center for Disease Control, over 70,000 people died of opioid overdose between 1999 and 2017; about 68% of those involved a prescription or illicit opioid.

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