The Justice Department has announced a significant crackdown on healthcare fraud, charging nearly 200 individuals in schemes involving false claims amounting to over $2.7 billion. Attorney General Merrick Garland revealed that the charges target a wide range of professionals, including doctors, nurse practitioners, and other licensed medical personnel across the United States. The crackdown includes a particularly egregious $900 million scheme in Arizona that preyed on terminally ill patients.
Garland emphasized the department’s commitment to holding all wrongdoers accountable, regardless of their position. “It does not matter if you are a trafficker in a drug cartel or a corporate executive or medical professional employed by a healthcare company,” Garland stated. “If you profit from the unlawful distribution of controlled substances, you will be held accountable.”
In Arizona, prosecutors have accused Alexandra Gehrke and Jeffrey King, owners of wound care companies, of accepting over $330 million in kickbacks. They allegedly billed Medicare fraudulently for amniotic wound grafts, which are used to help heal wounds. Nurse practitioners were reportedly pressured to apply these grafts to elderly patients who did not need them, including those in hospice care. Tragically, some patients died shortly after receiving the grafts.
In less than two years, more than $900 million in false claims were submitted to Medicare for these grafts, which were used on fewer than 500 patients. Gehrke and King were arrested at the Phoenix airport while attempting to board a flight to London. Authorities found books in their possession on how to disappear and survive the legal system, suggesting they were preparing to flee.
Prosecutors allege that Gehrke and King lived lavishly off the scheme, citing luxury cars, a nearly $6 million home, and over $520,000 in gold bars, coins, and jewelry. Officials seized more than $52 million from Gehrke’s personal and business bank accounts following her arrest.
In total, 193 individuals, including 76 medical professionals, were charged in various cases over a two-week period. Authorities seized more than $230 million in cash, luxury cars, and other assets. These periodic sweeps by the Justice Department aim to deter potential wrongdoers.
Another significant case involved a scheme targeting Native Americans. Phony sober living homes were established, promising addiction treatment but submitting claims for services that were never performed. In Florida, a scheme to distribute misbranded HIV drugs was uncovered. Prosecutors allege that drugs were bought on the black market and resold to unsuspecting pharmacies, which then provided the medications to patients. Some patients received bottles containing different drugs than the labels indicated, leading to severe consequences. One patient was unconscious for 24 hours after taking what he believed was his HIV medication but was actually an anti-psychotic drug.
The Justice Department’s efforts also uncovered schemes involving the unlawful distribution of millions of Adderall pills, the establishment of phony sober living homes, and the illegal prescription or distribution of opioids. These cases highlight the diverse and widespread nature of healthcare fraud in the United States.
In another Arizona case, a woman was accused of billing the state’s Medicaid agency for substance abuse treatment services that were either unnecessary or never provided. The scheme involved setting up sham sober homes and billing the healthcare system for millions of dollars for services not rendered. The accused targeted vulnerable Native Americans, posing significant risks to the quality of care they needed and deserved.
The Justice Department also charged Rita Anagho of San Tan Valley in connection with a $69 million scheme involving a drug abuse treatment center called Tusa Integrated Clinic. The clinic allegedly submitted false claims to Arizona’s Health Care Cost Containment System (AHCCCS) for services not provided and created false therapy notes. AHCCCS paid Tusa $55 million.
Additionally, Adam Mutwol of Tempe and Daud Koleosho of Gilbert were charged with conspiracy to commit healthcare fraud. They allegedly billed AHCCCS for $57 million through their ownership of Community Hope Wellness Center, offering kickbacks and bribes to those who housed patients in need of substance abuse treatment. AHCCCS paid the clinic $51 million.
These cases underscore the Justice Department’s ongoing commitment to combating healthcare fraud and protecting vulnerable populations. The department’s efforts aim to ensure that those who exploit patients and defraud government programs are held accountable for their actions.
Source: Associated Press, CNN
