Regulatory

DOJ charges 149 people for hundreds of millions of dollars of healthcare fraud, drug diversion

by Paige Minemyer | Sep 30, 2019

The Department of Justice (DOJ) announced several healthcare fraud takedowns of late, resulting in dozens of charges, including many against medical professionals. 

Across the three fraud takedowns, 149 people were charged across fraud schemes totaling millions billed unlawfully to government and private payers.  

“Physicians and other medical professionals who fraudulently bill our federal healthcare programs are stealing from taxpayers and robbing vulnerable patients of necessary medical care,” said Brian Benczkowski, assistant attorney general in the DOJ’s criminal division. “The Department of Justice will continue to use every tool at our disposal, including data analytics and traditional law enforcement techniques, to investigate, prosecute and punish this reprehensible behavior and protect federal programs from abuse.” 

Here’s a look at the results of the three takedowns: 

Florida, Georgia takedown leads to charges against 67 people 

DOJ filed charges against 67 people in Georgia and Florida for fraud schemes totaling more than $160 million in unlawful bills to Medicare, Medicaid and private insurance. In a number of cases, those charged allegedly submitted bills for unnecessary care including home health, prescription drugs and durable medical equipment. 

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Mike Adams

Mike Adams is a medical device sales leader with extensive clinical experience in spine and biologics and a nationwide distribution network built over the last 10+ years in the industry. He has held various leadership positions in healthcare and device including Distributor Partner, Hospital COO and Spine VP of Sales. He currently leads the commercialization strategy for OrthoSpine Partners and is a Distributor Principal at Novel Medical. Because of his unique career path, Mike has the ability to see the healthcare business from multiple perspectives making him passionate about building strategic partnerships that help reduce overall costs, drive innovation, and cultivate growth for new markets.

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