US says it has halted healthcare fraud schemes worth nearly $15bn

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"U.S. Justice Department Halts Major Healthcare Fraud Schemes Totaling $14.6 Billion"

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The U.S. Department of Justice announced on Monday the completion of a significant operation that dismantled multiple healthcare fraud schemes aimed at defrauding the federal government of approximately $14.6 billion. This initiative is being hailed as the largest healthcare fraud enforcement action in the department's history, leading to the indictment of 324 individuals and the confiscation of more than $245 million in cash and assets, including luxury vehicles. According to officials, the actual financial loss incurred by the government was around $2.9 billion. Matthew Galeotti, the head of the Justice Department's criminal division, emphasized the importance of this operation in safeguarding American taxpayers and maintaining the integrity of the healthcare system during a press conference. Among those charged are 93 medical professionals, including doctors, who allegedly submitted fraudulent claims to government healthcare programs such as Medicare and Medicaid.

The fraud schemes were reportedly orchestrated by transnational criminal organizations based outside the United States, which have increasingly targeted the American healthcare system with sophisticated fraud tactics. One particularly notable case involved a network operating from Russia and Eastern European countries, resulting in charges against 19 individuals, with 12 arrests made. This group is accused of utilizing a web of foreign straw owners to acquire numerous U.S. medical supply companies and, by exploiting stolen American identities, submitted over $10 billion in false claims to Medicare. One victim of this scheme, 73-year-old Gerald Quindry, reported being billed $15,500 for urinary catheters that he neither ordered nor received, highlighting the serious implications of such fraudulent activities. Dr. Mehmet Oz, the administrator for the Centers for Medicare & Medicaid Services, noted that these operations are not conducted by small-time fraudsters, but rather by organized syndicates with the intention of causing harm to the American healthcare system.

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The US justice department said on Monday that it halted a series ofhealthcarefraud schemes that sought to bilk the federal government out of $14.6bn.

The operation, which the department called the largest healthcare fraud initiative in its history, led to criminal charges against 324 defendants and the seizure of more than $245m in cash, luxury cars and other assets. The actual loss to the US government totaled about $2.9bn, officials said.

“Today marks a decisive moment in our fight to protect American taxpayers from fraudsters and to defend the integrity of America’s healthcare system,” Matthew Galeotti, the head of the justice department’s criminal division, told reporters during a press conference.

Those charged include 93 doctors and other medical professionals accused of submitting false claims to government healthcare programs like Medicare and Medicaid.

Some of the schemes were run by transnational criminal organizations based outside the US, that have been perpetrating increasingly complex fraud operations targeting the American healthcare system, justice department officials said.

One such scheme, which prosecutors said was run out of Russia and eastern European countries, led to charges against 19 defendants, 12 of whom have been arrested.

The group used a network of foreign straw owners to buy dozens of US medical supply companies and, using stolen American identities, submitted more than $10bn in fraudulent claims to Medicare, according to the justice department.

Among those whose identities were compromised was Gerald Quindry, a 73-year-old retired engineer on Medicare. He was billed $15,500 for urinary catheters, though his doctor never ordered them nor did Quindry want nor receive them, as theWashington Postreported.

Quindry – who told the Post, “obviously, somebody deserves to be in jail” over the plot – had complained to Medicare, but program representatives had initially seemed unbothered.

“It’s not being done by small-time operators,” said Dr Mehmet Oz, the administrator for the Centers for Medicare & Medicaid Services. “These are organized syndicates who are designing to hurt America.”

Guardian staff contributed

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Source: The Guardian