Federal prosecutors unsealed dozens of cases against nearly 80 defendants across the country alleging they engaged in healthcare and pharmaceutical fraud schemes that led to $2.5 billion in total losses to Medicare, Medicaid and private insurance.
— Federal prosecutors unsealed dozens of cases against nearly 80 defendants across the country — including 24 medical providers — alleging they engaged in healthcare and pharmaceutical fraud schemes that led to $2.5 billion in total losses to Medicare, Medicaid and private insurance, the Justice Department said Wednesday. More than $1 billion in alleged fraudulent claims were paid out, investigators said.
The indictment alleges the suppliers and sellers worked to"deceive pharmacies, patients, and health care programs into believing that their supply of prescription drugs was legitimate." "The false and fraudulent doctors' orders to maximize reimbursement from the Federal Health Care Plans; defeat audits conducted by the Federal Health Care Plans; and conceal and disguise the scheme," the indictment alleges. Investigators say the prescriptions in question would have been deemed ineligible for reimbursement without the fraudulent submissions.
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