**East Tennesseans Charged in National Health Care Fraud Investigation**
In a historic crackdown on health care fraud, Attorney General Jeff Sessions and Health and Human Services (HHS) Secretary Alex M. Azar III announced the largest enforcement action of its kind. The operation led to charges against 601 defendants across 58 federal districts, including 165 medical professionals, for their alleged involvement in schemes that resulted in over $2 billion in false billings. Among those charged, 162 defendants, including 76 doctors, were implicated in the illegal prescription and distribution of opioids and other narcotics.
The investigation saw the participation of 30 state Medicaid Fraud Control Units and resulted in the exclusion of 2,700 individuals from federal health care programs, including 587 providers for opioid-related misconduct.
**East Tennessee Defendants**
Six individuals from East Tennessee were among those charged. Caleb Mullins, 40, and Megan Mullins, 37, both of Oak Ridge, along with their company CAMM Care, LLC, doing business as Patriot Homecare, were indicted for defrauding the U.S. Department of Labor’s Office of Worker’s Compensation Program, Division of Energy Employees, Occupational Illness Compensation (DOL-DEEOIC). The indictment alleges that Caleb and Megan Mullins conspired to submit fraudulent claims for homecare services that were never provided.
Three other East Tennesseans—Samantha Seiber, 35, of Wartburg; Apryl Hard, 46, of Louisville; and Lois Hamby, 62, of Oliver Springs—were also charged in separate indictments. They allegedly used their DOL-DEEOIC provider numbers to bill for skilled nursing services that were not rendered.
**National Scope of the Investigation**
The nationwide operation was coordinated by the Criminal Division’s Fraud Section’s Health Care Fraud Unit in conjunction with its Medicare Fraud Strike Force (MFSF) partners. The operation involved multiple federal agencies, including the FBI, DEA, IRS Criminal Investigation (CI), and the Defense Criminal Investigative Service (DCIS), among others.
The charges target schemes that billed Medicare, Medicaid, TRICARE, and private insurers for unnecessary prescription drugs and compounded medications, many of which were never purchased or distributed. The investigation also focused on medical professionals contributing to the opioid epidemic, a significant concern given the CDC’s report that approximately 115 Americans die daily from opioid-related overdoses.
**Statements from Officials**
Attorney General Sessions emphasized the gravity of health care fraud, describing it as a betrayal of vulnerable patients and theft from taxpayers. He highlighted the Department of Justice’s efforts to combat fraud through increased prosecution and data analytics. Sessions praised the collaboration with federal, state, local, and tribal law enforcement officers, noting that the operation had prevented billions of dollars in fraud.
HHS Secretary Azar underscored the importance of recovering taxpayer money to fund essential health care services. He commended the public servants involved in the operation for their significant achievement.
**Details of the Fraud Schemes**
The defendants allegedly participated in schemes to submit fraudulent claims to Medicare, Medicaid, TRICARE, and private insurers for treatments that were medically unnecessary or never provided. In many cases, patient recruiters, beneficiaries, and other co-conspirators were paid kickbacks for supplying beneficiary information, enabling providers to submit fraudulent bills.
The involvement of medical professionals is particularly concerning, as their participation is often crucial for Medicare or Medicaid to pay fraudulent claims. Pursuing corrupt medical professionals not only deters others but also ensures that their licenses cannot be used to exploit the system.
**Impact on Health Care Programs**
FBI Deputy Director David L. Bowdich highlighted the widespread impact of health care fraud, noting that it not only costs taxpayers money but can also have deadly consequences. He pointed out that some medical professionals prioritized greed over patient well-being, exacerbating the opioid crisis.
DEA Assistant Administrator John Martin reiterated the agency’s commitment to ending the opioid crisis and preventing prescription drug misuse. He emphasized the importance of collaboration with partners to protect citizens while ensuring access to necessary medications.
HHS Deputy Inspector General Gary Cantrell noted the significant progress made in combating health care fraud but stressed that efforts are ongoing. He emphasized the importance of protecting Medicare and Medicaid programs and their beneficiaries.
**Additional Cases and Investigations**
The Medicare Fraud Strike Force operations are part of a joint initiative between the Department of Justice and HHS to prevent and deter fraud. Since its inception in 2007, the Strike Force has charged over 3,700 defendants, who collectively billed Medicare for over $14 billion.
In the Southern District of Florida, 124 defendants were charged with offenses related to various fraud schemes involving over $337 million in false billings. In the Central District of California, 33 defendants were charged in schemes defrauding insurance programs of more than $660 million. Other significant cases were reported in Texas, Michigan, Illinois, New York, and several other states.
**Conclusion**
The unprecedented scale of this enforcement action underscores the commitment of federal and state agencies to combat health care fraud and opioid abuse. The charges against East Tennesseans are part of a broader effort to protect vulnerable patients and ensure the integrity of health care programs.
Source: U.S. Department of Justice, Health and Human Services, Federal Bureau of Investigation
