Florida Nurses, Pharmacists Involved in National Health Care Fraud Scheme

Health care fraud and abuse is a national epidemic, costing billions of dollars every year. Many of these schemes are performed by medical staff charging for services and prescriptions that were never provided. These acts affect everyone and cause health care costs to rise.

Fortunately, our country is fighting hard to prevent future acts of insurance fraud. The Department of Justice was recently involved in the largest health care fraud scheme ever.  The Medicare Fraud Strike Force uncovered $1.3 billion in billing fraud. More than 400 people were charged with fraud and more than 100 people were accused of illegally prescribing opioids and other narcotics, including Florida nurses and pharmacists.

Many of these medical providers will lose their license. In fact, the Department of Health and Human Services is in the process of suspending the licenses of 295 providers, including nurses and pharmacists.

Putting Greed Above Patients

The takedown was announced on July 14. The violations involved billing schemes that targeted Medicare, Medicaid and TRICARE. The providers billed for unnecessary prescription drugs, including opioids and other narcotics. This especially is a huge concern for Department of Health and Human Services, with more than 90 Americans dying from opioid overdoses daily.

The providers were receiving reimbursement for these drugs while feeding addictions. They were prescribing excessive amounts of opioids to patients who did not need them.

Many of the providers also billed for treatments that were never performed. It is believed that recruiters and conspirators were given cash for doling out beneficiary information to providers. The providers then used this information to submit fraudulent bills to Medicare.

The fraud schemes occurred all over the country, but many of the defendants were operating in Florida. In the Southern District of Florida, 77 defendants are facing charges for fraud. They were involved in $141 million in false billings for home health care, mental health services and pharmaceuticals. One egregious case involved an addiction treatment center that submitted $58 million in fraudulent insurance claims for drug treatment services that were never rendered.

In the Middle District of Florida, 10 people were involved in a billing scheme that amounted to almost $14 million in false claims. In one case, three defendants were charged with defrauding the TRICARE program of $4 million. One of the defendants falsely represented himself to be a retired sevicemember so he could obtain personal information from TRICARE beneficiaries. 

Keep Your License with Help From a Tampa Administrative Lawyer 

Unfortunately, fraud is common in many industries. The medical field is no exception. Staff members know how to take advantage of the billing and prescribing processes to defraud insurers. As a result, they put their license on the line.

If you are accused of fraud or some other crime that could potentially lead to license suspension or revocation, get legal representation from the Law Offices of David P. Rankin, P.A. I am a Tampa administrative lawyer who can help formulate a solid defense so you can hold onto your license. Don’t give up without a fight. Contact my office today for a consultation by calling (813) 968-6633.

Resource:

http://www.floridatrend.com/article/22581/national-health-care-fraud-takedown-results-in-charges-against-over-412-individuals-responsible-for-13-billion-in-fraud-losses