Channel Sponsor - Coding/Billing/Collections

Sponsored by National Medical Billing Services | info@nationalASCbilling.com | (636) 273-6711

'Takedown Day' worth $2B: 165 medical professionals charged in largest-ever healthcare fraud action

More than 600 defendants — including 165 doctors, nurses and other licensed medical professionals — were charged for allegedly participating in healthcare fraud schemes involving more than $2 billion in false billings. 

Here's what you should know:

1. The defendants are accused of taking part in schemes to submit claims to Medicare, Medicaid, TRICARE and private insurance companies for medically unnecessary treatments or ones that were never provided.

2. Of the 162 defendants charged for their roles in prescribing and distributing opioids and other narcotics, 76 were physicians.

3. Attorney General Jeff Sessions and HHS Secretary Alex M. Azar III announced the charges June 28. It was the largest healthcare fraud enforcement action in American history, which Mr. Azar referred to as "Takedown Day" in the news release.

4. Since July 2017, HHS has excluded 2,700 individuals from participation in Medicare, Medicaid and all other federal healthcare programs. The agency excluded 587 providers for opioid diversion and abuse.

5. In many cases, patient recruiters, beneficiaries and other co-conspirators allegedly received kickbacks for giving providers beneficiary information to help the providers falsely bill Medicare.

"This is the most fraud, the most defendants and the most doctors ever charged in a single operation — and we have evidence that our ongoing work has stopped or prevented billions of dollars' worth of fraud," said Attorney General Sessions.

More articles on coding, billing and collections:
HHS officials to meet with drug manufacturers to seek voluntary price cuts — 4 insights
Pain physician admits to kickbacks from 3 companies in plea deal, to pay $2.8M in civil settlement: 4 things to know
Coder claims Mosaic Life Care fired her for fighting billing fraud — 6 insights

© Copyright ASC COMMUNICATIONS 2019. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.

 

Top 40 Articles from the Past 6 Months