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Opioid crisis at centre of US healthcare fraud operation

The "largest healthcare fraud takedown operation in American history" has resulted in 412 people, including 56 doctors, being charged in connection with billing for drugs they never purchased and prescribing excessive quantities of opioids.

The scams – which included billing Medicare and Medicaid for drugs never purchased, collecting money for false rehabilitation treatments and tests, giving out prescriptions for cash, and prescribing excessive levels of opioids – have collectively cost $1.3bn.

"Too many trusted medical professionals like doctors, nurses, and pharmacists have chosen to violate their oaths and put greed ahead of their patients," Attorney General Jeff Sessions said in an announcement highlighting the enormity of the fraud challenge in the country. "Amazingly, some have made their practices into multimillion dollar criminal enterprises. They seem oblivious to the disastrous consequences of their greed."

The arrests followed years of healthcare fraud across more than 20 states.

Several case studies were given during the press announcement. As cited by the New York Times, one case allegedly involved a Florida drug-treatment centre where the owner recruited addicts from Alcoholic Anonymous meetings and "crack motels" to help him with his schemes, offering incentives such as drugs, plane tickets, and trips to casinos and strip clubs. In another case, A New York cardiologist allegedly referred business to medical diagnostic facilities in return for kickbacks.

Nearly a third of those charged – around 120 – were in connection with the excessive prescription of opioids. Prosecutors said during the press announcement that some doctors were writing more prescriptions for opioids in a month than a whole hospital. One doctor in Houston allegedly gave out 12,000 opioid prescriptions for more than two million illegal painkiller doses, while six doctors in Michigan allegedly operated a $164m scam prescribing patients with unnecessary opioids, some of which ended up for sale on the street.

The US is currently facing an opioid crisis, which has resulted in tens of thousands of overdoses and deaths. Counterfeit painkillers and anti-anxiety meds laced with the strong opioid fentanyl have flooded the market and law enforcement officials believe the fake drugs are fuelling the crisis, which they are now calling an epidemic.

According to Sessions, one American dies from a drug overdose every 11 minutes and more than 2 million Americans are addicted to prescription painkillers.

Sessions referred to the healthcare providers accused with opioid over-prescribing in the latest sting as "not only enriching themselves, often at the expense of taxpayers, but also feeding addictions and causing addictions to start."

The Attorney General has made it a priority to crackdown on drug crime, while the Trump administration has sought a budget of $70m to be invested in healthcare fraud control.

In 2007, a Medicare taskforce was established to investigate healthcare fraud, and has charged more than 3,500 people in that time for fraudulent activities amounting to more than $12.5bn. Last year, 301 people were charged for $900m worth of fraud.

"Thanks to these efforts, fewer criminals will be able to exploit our nation's opioid crisis for their own gain," said Tom Price, secretary of health and human services.

Sessions called the arrests historic but said the Department of Justice's work was not finished. "We will continue to find, arrest, prosecute, convict and incarcerate fraudsters and drug dealers wherever they are. We will use every tool we have to stop criminals from exploiting vulnerable people and stealing our hard-earned tax dollars. We are continuing to work hard to develop more techniques to identify and prosecute wrongdoers."

"We are sending a clear message to criminals across the country: we will find you. We will bring you to justice. And, you will pay a very high price for what you have done."


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