SUD facilities billed $845 million fraudulently, says DOJ

Abstract

More than 100 doctors, nurses and other licensed medical professionals were charged last month by the federal Department of Justice (DOJ) for submitting more than $6 billion in false and fraudulent claims to Medicare, Medicaid and private insurance companies. This included more than $845 million connected to “sober homes.” The enforcement action, announced Sept. 30, involved 345 defendants across 51 federal districts, and was led by the DOJ's Criminal Division. Prosecution will be by U.S. attorneys and the DOJ's Criminal Division's Fraud Section. The cases are connected to telemedicine, which has taken off since the COVID‐19 pandemic. “Telemedicine can foster efficient, high‐quality care when practiced appropriately and lawfully,” said Acting Assistant Attorney General Brian C. Rabbitt. “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,” said Department of Health and Human Services Deputy Inspector General Gary Cantrell. “Unfortunately, audacious schemes such as these are prevalent and often harmful. Therefore, collaboration is critical in our fight against health care fraud.” Rabbitt said the enforcement action will “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.”