Health Care

Almost 200 people charged in schemes totaling $2.7B in false health care claims

Attorney General Merrick Garland makes a statement during a press conference at the Department of Justice in Washington, D.C., on Thursday, June 27, 2024 to make an announcement on a national enforcement action against doctors, nurse practitioners, and other licensed medical professionals for over $2.7 billion in false billings.

Almost 200 people have been charged in a nationwide operation probing false health care claims involving approximately $2.75 billion in losses, the Department of Justice (DOJ) announced Thursday.

Under its 2024 National Health Care Fraud Enforcement Action, the DOJ filed charges against 193 defendants, including 76 doctors, nurse practitioners and other licensed medical professionals in 32 different federal districts across the country.

The DOJ said in a nationwide law enforcement action, the government seized “over $231 million in cash, luxury vehicles, gold, and other assets.”

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

According to the DOJ, the charges allege that five individuals and a digital technology company participated in a more than $900-million fraud scheme in Arizona in connection with amniotic wound grafts, the unlawful distribution of Adderall pills and other stimulants.

Prosecutors allege two owners of a wound care company accepted more than $330 million as part of a plan to fraudulently bill Medicare for wound grafts. Nurse practitioners were pressured to apply the wound grafts to patients who didn’t need them, including some people in hospice who died the day they received that care, The Associated Press reported.

The married owners of the company, Alexandra Gehrke and Jeffrey King, were arrested at the Phoenix airport before boarding a flight to London earlier this month. Officials say they knew the charges were coming because information was found in their home about erasing digital footprints, the AP reported.   

The DOJ also alleges corporate executives committed a $90 million fraud scheme by distributing adulterated and wrongfully branded HIV medication, more than $146 million in fake addiction treatment schemes, more than $1.1 billion in telemedicine and laboratory fraud, as well as $450 million in other health care fraud and opioid schemes.

Homeland Security Secretary Alejandro Mayorkas said his department’s agents were proud to play a part in the multi-agency investigation.

“Thought his action, we in federal law enforcement send a clear and strong message — that we will hold accountable those health care providers and prescribers who prey on their patients for profit and disregard the first rule of medical care: do no harm,” Mayorkas said in a statement.