A historic nationwide enforcement action involving 345 charged defendants across 51 federal districts, including more than 100 doctors, nurses and other licensed medical professionals, was announced on Wednesday by Acting Assistant Attorney General Brian C. Rabbitt of the Justice Department’s Criminal Division, Assistant Administrator Tim McDermott of the Drug Enforcement Administration (DEA), Assistant Director Calvin Shivers of the FBI’s Criminal Investigative Division, and Deputy Inspector General Gary Cantrell of the Department of Health and Human Services Office of Inspector General (HHS-OIG).
These defendants have been charged with submitting more than $6 billion in false and fraudulent claims to federal health care programs and private insurers, including more than $4.5 billion connected to telemedicine, more than $845 million connected to substance abuse treatment facilities, or “sober homes,” and more than $806 million connected to other health care fraud and illegal opioid distribution schemes across the country.
(Acting Assistant Attorney General Brian Rabbitt announces cases that charge more than 300 individuals with health care fraud schemes involving more than six billion dollars in alleged health care fraud and millions of prescription opioid doses. Courtesy of Bloomberg QuickTake: Now and YouTube. Posted on Sep 30, 2020.)
Wednesday’s enforcement actions were led and coordinated by the Criminal Division, Fraud Section’s Health Care Fraud Unit, in conjunction with its Health Care Fraud and Appalachian Regional Prescription Opioid (ARPO) Strike Force program, and its core partners, the DEA, which was recognized in the 2019 ‘ASTORS’ Homeland Security Awards Program for Excellence in Public Safety, the U.S. Attorney’s Offices, HHS-OIG, and FBI, as part of the Department’s ongoing efforts to combat the devastating effects of health care fraud and the opioid epidemic.
These case are being prosecuted by Health Care Fraud and ARPO Strike Force teams from the Criminal Division’s Fraud Section, along with 43 U.S. Attorney’s Offices nationwide, and agents from DEA, HHS-OIG, FBI, and other various federal and state law enforcement agencies.
“The opioid epidemic our country is battling is exacerbated when unscrupulous individuals seek to profit from people, in particular those confronting addiction,” explained DEA Assistant Administrator McDermott.
“When doctors, pharmacists, and individuals exploit the weakness of a fellow human being in order to line their own pockets, DEA will use every tool at its disposal to stop and bring them to justice.”
“This nationwide enforcement operation is historic in both its size and scope, alleging billions of dollars in healthcare fraud across the country,” added Acting Assistant Attorney General Rabbitt.
“These cases hold accountable those medical professionals and others who have exploited health care benefit programs and patients for personal gain.”
“The cooperative law enforcement actions announced today send a clear deterrent message and should leave no doubt about the department’s ongoing commitment to ensuring the safety of patients and the integrity of health care benefit programs, even amid a national health emergency.”
“Every dollar saved is critical to the sustainability of our Medicare program and the needs of our beneficiaries,” said Centers for Medicare & Medicaid Services Administrator Seema Verma.
“We thank our partners at the Department of Justice and Department of Health and Human Services Office of Inspector General for working hard with us to identify, investigate, and eliminate waste, fraud and abuse in our federal healthcare programs.”
Telemedicine Fraud Cases
The largest amount of alleged fraud loss charged in connection with these cases – $4.5 billion in allegedly false and fraudulent claims submitted by more than 86 criminal defendants in 19 judicial districts – relates to schemes involving telemedicine: the use of telecommunications technology to provide health care services remotely.
According to court documents, certain defendant telemedicine executives allegedly paid doctors and nurse practitioners to order unnecessary durable medical equipment, genetic and other diagnostic testing, and pain medications, either without any patient interaction or with only a brief telephonic conversation with patients they had never met or seen.
Durable medical equipment companies, genetic testing laboratories, and pharmacies then purchased those orders in exchange for illegal kickbacks and bribes and submitted false and fraudulent claims to Medicare and other government insurers.
In addition to the criminal charges announced, CMS Center for Program Integrity has separately announced that it has taken a record-breaking number of administrative actions related to telemedicine fraud, revoking the Medicare billing privileges of 256 additional medical professionals for their involvement in telemedicine schemes.
“Telemedicine can foster efficient, high-quality care when practiced appropriately and lawfully,” said HHS Deputy Inspector General Cantrell.
“Unfortunately, bad actors attempt to abuse telemedicine services and leverage aggressive marketing techniques to mislead beneficiaries about their health care needs and bill the government for illegitimate services.”
“Unfortunately, audacious schemes such as these are prevalent and often harmful. Therefore, collaboration is critical in our fight against health care fraud.”
“We will continue working with our law enforcement partners to hold accountable those who steal from federal health programs and protect the millions of beneficiaries who rely on them.”
The continued focus on prosecuting health care fraud schemes involving telemedicine builds on the efforts and impact of the 2019 “Operation Brace Yourself” Telemedicine and Durable Medical Equipment Takedown, which resulted in an estimated cost avoidance of more than $1.5 billion in the amount paid by Medicare for orthotic braces in the seventeen months following that takedown.
(Learn More about “Operation Brace Yourself”; a scheme whereby Medicare was scammed out of $1 billion in healthcare funds. Courtesy of WSPA 7News and YouTube. Posted on Apr 9, 2019.)
“Sober Homes” Cases
The “sober homes” cases announced include charges against more than a dozen criminal defendants in connection with more than $845 million of allegedly false and fraudulent claims for tests and treatments for vulnerable patients seeking treatment for drug and/or alcohol addiction.
The subjects of the charges include physicians, owners and operators of substance abuse treatment facilities, as well as patient recruiters (referred to in the industry as “body brokers”).
These individuals are alleged to have participated in schemes involving the payment of illegal kickbacks and bribes for the referral of scores of patients to substance abuse treatment facilities; those patients were subjected to medically unnecessary drug testing – often billing thousands of dollars for a single test – and therapy sessions that were frequently not provided, and which resulted in millions of dollars of false and fraudulent claims being submitted to private insurers.
Medical professionals also allegedly prescribed medically unnecessary controlled substances and other medications to these patients, sometimes to entice them to stay at the facility.
The patients were then often discharged and admitted to other treatment facilities, or referred to other laboratories and clinics, in exchange for more kickbacks.
“The FBI, together with our federal, state, and local partners, remains steadfast in our commitment to identify and root out health care fraud, no matter what form it takes,” said FBI Assistant Director Shivers.
“We will continue to work tirelessly to ensure public and private health care dollars are used as intended, to promote the health and safety of all Americans and safeguard continued access to critical health care services.”
Cases Involving the Illegal Prescription and/or Distribution of Opioids
And Cases Involving Traditional Health Care Fraud Schemes
The cases involving the illegal prescription and/or distribution of opioids or that fall into more traditional categories of health care fraud include charges and guilty pleas involving more than 240 defendants who allegedly participated in schemes to submit more than $800 million in false and fraudulent claims to Medicare, Medicaid, TRICARE, and private insurance companies for treatments that were medically unnecessary and often never provided.
According to court documents, in many cases, patient recruiters, beneficiaries and other co-conspirators were allegedly paid cash kickbacks in return for supplying beneficiary information to providers, so that the providers could then submit fraudulent bills to Medicare.
Also included are charges against medical professionals and others involved in the distribution of more than 30 million doses of opioids and other prescription narcotics.
National Rapid Response Strike Force
In connection with the nationwide enforcement action, the Department of Justice also announced the creation of the National Rapid Response Strike Force of the Health Care Fraud Unit of the Criminal Division’s Fraud Section.
The National Rapid Response Strike Force’s mission is to investigate and prosecute fraud cases involving major health care providers that operate in multiple jurisdictions, including major regional health care providers operating in the Criminal-Division-led Health Care Fraud Strike Forces throughout the United States.
The National Rapid Response Strike Force led the telemedicine initiative and helped lead the sober homes cases included in the announcement.
Prior to the charges announced as part of the nationwide enforcement action and since its inception in March 2007, the Health Care Fraud Strike Force program had charged more than 4,200 defendants who have collectively billed the Medicare program for approximately $19 billion.
A complaint, information or indictment is merely an allegation, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.
DEA Honored in 2019 ‘ASTORS’ Homeland Security Awards Program
Excellence in Homeland Security
The National Prescription Drug Take Back Day Initiative
The National Prescription Drug Take Back Day hosted by the DEA and its national, tribal and community partners aims to provide a safe, convenient, and responsible means of disposing of prescription drugs, while also educating the general public about the potential for abuse of medications.
The U.S. Coast Guard, ICE ERO and FBI IC3 Nominated in the 2020 ‘ASTORS’ Homeland Security Awards Program
Last Days to Compete in the 2020 ‘ASTORS’ Homeland SecurityAwards at https://americansecuritytoday.com/ast-awards/.
The Annual ‘ASTORS’ Awards Program is specifically designed to honor distinguished government and vendor solutions that deliver enhanced value, benefit and intelligence to end users in a variety of government, homeland security and public safety vertical markets.
The Annual ‘ASTORS’ Awards is the preeminent U.S. Homeland Security Awards Program highlighting the most cutting-edge and forward-thinking security solutions coming onto the market today, to ensure our readers have the information they need to stay ahead of the competition, and keep our Nation safe – one facility, street, and city at a time.
90% of ‘ASTORS’ Award Winners return to compete in the Annual ‘ASTORS‘ Homeland Security Awards Program, and 100% of ‘ASTORS’ Sponsors have returned year to year to reap the benefits of their participation in the industry’s largest and most comprehensive Annual Awards Program.
Nominations are now being accepted for the 2020 ‘ASTORS’ Homeland Security Awards at https://americansecuritytoday.com/ast-awards/.
|Access Control/ Identification||Personal/Protective Equipment||Law Enforcement Counter Terrorism|
|Perimeter Barrier/ Deterrent System||Interagency Interdiction Operation||Cloud Computing/Storage Solution|
|Facial/IRIS Recognition||Body Worn Video Product||Cyber Security|
|Video Surveillance/VMS||Mobile Technology||Anti-Malware|
|Audio Analytics||Disaster Preparedness||ID Management|
|Thermal/Infrared Camera||Mass Notification System||Fire & Safety|
|Metal/Weapon Detection||Rescue Operations||Critical Infrastructure|
|License Plate Recognition||Detection Products||And Many Others!|
Don’t see a Direct Hit for your Product, Agency or Organization?
With the unprecedented occurrence of the COVID-19 pandemic, the focus of the safety and security industries has realized the need to increase innovations to address the daily growing challenges.
As such AST aims to make sure these firms and professionals are reflected in the 2020 ‘ASTORS’ Awards Program, so we’d like to encourage you to submit appropriate categories recommendations and include COVID-19 Frontline Professionals in your Nominations to see that these Professionals, Facilities, and Vendors receive the Recognition they Deserve!
Submit your category recommendation for consideration to Michael Madsen, AST Publisher at: email@example.com.
The 2019 ‘ASTORS’ Awards Program surpassed expectations with a record number of nominations received from industry leaders and government agencies, and drew over 200 attendees to the ‘ASTORS’ Awards Presentation Banquet – an exclusive gourmet luncheon and networking opportunity which filled to capacity, before having to turn away late registrants.
The event featured an impassioned and compelling keynote address by William J. Bratton, former police commissioner of the New York Police Department (NYPD) twice, the Boston Police Department (BPD), and former chief of the Los Angeles Police Department (LAPD), as he walked attendees through 50 years of American policing history, the impacts on the communities, and the evolution of critical communication capabilities in our post 9/11 landscape.
Commissioner Bratton, one of the world’s most respected and trusted experts on risk and security issues and Executive Chairman of Teneo Risk a global advisory firm, was recognized as the ‘2019 ‘ASTORS’ Person of the Year’ for his Lifetime of Dedication and Extraordinary Leadership in Homeland Security and Public Safety.
The 2019 ‘ASTORS’ Awards Program was sponsored by ATI Systems, Attivo Networks, Automatic Systems, Desktop Alert, and SWORD Technologies, every one a returning Sponsor from 2018.
Why the ‘ASTORS’ Homeland Security Awards Program?
American Security Today’s comprehensive Annual Homeland Security Awards Program is organized to recognize the most distinguished vendors of physical, IT, port security, law enforcement, and first responders, in acknowledgment of their outstanding efforts to ‘Keep our Nation Secure, One City at a Time.’
Over 200 distinguished guests representing Federal, State and Local Governments, and Industry Leading Corporate Firms, gathered from across North America, Europe and the Middle East to be honored among their peers in their respective fields which included:
- The Drug Enforcement Administration (DEA)
- National Center for Missing and Exploited Children (NCMEC)
- United States Marine Corps
- The Federal Protective Service (FPS)
- Argonne National Laboratory (ANL)
- United States Postal Inspection Service
- DHS S&T
- United States Marshals Service (USMS)
- The Port Authority of New York & New Jersey Police (PAPD)
- The Department of Justice (DOJ)
- The New York State Division of Homeland Security & Emergency Services (NYS DHSES)
- United States Border Patrol
- AlertMedia, Ameristar Perimeter Security, Attivo Networks, Automatic Systems, Bellevue University, BriefCam, Canon U.S.A., CornellCookson, Drone Aviation, FLIR Systems, Hanwha Techwin, HID Global, IPVideo Corp., Konica Minolta Business Solutions, LenelS2, ManTech, Regroup Mass Notifications, SafeLogic, SolarWinds, Senstar, ShotSpotter, Smiths Detection, TCOM LP, Trackforce, Verint, and More!
From innovative Military Cyber Programs, to Local, State and Federal Public Safety and Emergency Management Initiatives, New Physical and IT Products and Services, and Security Professional, Threat Assessment, Emergency Preparedness, Law Enforcement and Homeland Security Education and Training Opportunities – Join your ‘ASTORS’ Award-Winning Peers and Receive the Recognition You Deserve!
Excellence in Public Safety and Government Security Award Nominations are encouraged, such as 2019 Honored Winners which includes the DEA, U.S. Marine Corps, DHS S&T, Federal Protective Police, DHS S&T NUSTL, U.S. Marshals Service, U.S. Border Patrol, The Port Authority of NY/NJ, and the NYS Division of Homeland Security & Emergency Services.
Individuals are also encouraged to be nominated for Government Excellence in Public Safety and Homeland Security such as last years widely respected recipients.
2019 ‘ASTORS’ EXCELLENCE AND GOVERNMENT AWARD RECIPIENTS
Commissioner William Bratton, Executive Chairman of Teneo Risk, the ‘2019 ‘ASTORS’ Person of the Year’
John F. Clark, CEO of the National Center for Missing and Exploited Children (NCMEC)
DHS S&T Next Generation First Responder (NGFR) Program
Dean C. Alexander, Director, Homeland Security Research Program & Professor at Western Illinois University
DHS S&T Office of Mission and Capability Support (Forensic Video Exploitation and Analysis) Tool Suite
Grant Coffey, Portland Fire & Rescue Hazmat Team Coordinator (Ret), CBRNE Industry Expert
Sheriff Tom Knight, Sarasota County Sheriff (FL)
Dr. Sean Lawler
United States Border Patrol, Border Patrol, Search, Trauma and Rescue (BORSTAR)
Dr. Konstantinos Papazoglou and Dr. Daniel M. Blumberg, Co Authors of ‘Power: Police Officer Wellness, Ethics, and Resilience’
United States Marine Corps, U.S. Marine Corps 1700 Cyberspace Operations
Congressman Brian Fitzpatrick (PA)
DOJ OPM Federal Risk Management Process Training Program
NYS Division of Homeland Security & Emergency Services UAS/Drone Training Program
Ewart Williams, New Jersey City University National Security and Intelligence Adjunct Professor
Stanley I. White, International Association for Counterterrorism & Security Professionals (IACSP)
Why American Security Today?
The traditional security marketplace has long been covered by a host of publications putting forward the old school basics to what is Today – a fast changing security landscape.
The traditional security marketplace has long been covered by a host of publications putting forward the old school basics to what is Today – a fast changing security landscape.
American Security Today is uniquely focused on the broader Homeland Security & Public Safety marketplace with over 75,000 readers at the Federal, State and local levels of government as well as firms allied to government.
American Security Today brings forward a fresh compelling look and read with our customized digital publications that hold readers eyes throughout the story with cutting edge editorial that provides solutions to their challenges.
Harness the Power of the Web – with our 100% Mobile Friendly Publications
The AST Digital Publications is distributed to over 75,000 qualified government and homeland security professionals in federal, state and local levels.
‘PROTECTING OUR NATION, ONE CITY AT A TIME’
AST Reaches both Private & Public Experts, essential to meeting these new challenges.
Today’s new generation of public safety and security experts need real-time knowledge to deal with domestic and international terrorism, lone wolf attacks, unprecedented urban violence, shifts in society, culture and media bias – making it increasingly difficult for Homeland Security, Law Enforcement, First Responders, Military and Private Security Professionals to implement coordinated security measures to ensure national security and improve public safety.
These experts are from Government at the federal, state and local level as well as from private firms allied to government.
AST provides a full plate of topics in our AST Monthly Magazine Editions, AST Website and AST Daily News Alerts, covering 23 Vital Sectors such as Access Control, Perimeter Protection, Video Surveillance/Analytics, Airport Security, Border Security, CBRNE Detection, Border Security, Ports, Cybersecurity, Networking Security, Encryption, Law Enforcement, First Responders, Campus Security, Security Services, Corporate Facilities, and Emergency Response among others.
AST has Expanded readership into integral Critical Infrastructure audiences such as Protection of Nuclear Facilities, Water Plants & Dams, Bridges & Tunnels, and other potential targets of terrorism.
Other areas of concern include Transportation Hubs, Public Assemblies, Government Facilities, Sporting & Concert Stadiums, our Nation’s Schools & Universities, and Commercial Business Destinations – all enticing targets due to the large number of persons and resources clustered together.
To learn more about the 2019 ‘ASTORS’ Homeland Security Award Winners solutions, please go to the 2019 ‘ASTORS’ Championship Edition Fully Interactive Magazine – the Best Products of 2019 ‘A Year in Review’.
The ‘ASTORS’ Champion Edition is published annually and includes a review of the ‘ASTORS’ Award Winning products and programs, highlighting key details on many of the winning firms products and services, includes video interviews and more.
It is your Go-To source throughout the year for ‘The Best of 2019 Products and Services‘ endorsed by American Security Today, and can satisfy your agency’s and organization’s most pressing Homeland Security and Public Safety needs.
From Physical Security (Access Control, Critical Infrastructure, Perimeter Protection and Video Surveillance Cameras and Video Management Systems), to IT Security (Cybersecurity, Encryption, Data Storage, Anti-Malware and Networking Security – Just to name a few), the 2019 ‘ASTORS’ CHAMPIONS EDITION will have what you need to Detect, Delay, Respond to, and Mitgate today’s real-time threats in our constantly evolving security landscape.
It also includes featured guest editorial pieces from some of the security industry’s most respected leaders, and recognized firms in the 2019 ‘ASTORS’ Awards Program.
For information about advertising opportunities with American Security Today, please contact Michael Madsen, AST Publisher at firstname.lastname@example.org.
AST strives to meet a 3 STAR trustworthiness rating, based on the following criteria:
- Provides named sources
- Reported by more than one notable outlet
- Includes supporting video, direct statements, or photos