HHS-OIG and Law Enforcement Partners Tackle $2.75 Billion Healthcare Fraud Schemes
The Department of Health and Human Services Office of Inspector General (HHS-OIG) and its law enforcement partners have tackled nationwide healthcare fraud schemes involving around $2.75 billion in intended losses and $1.6 billion in actual losses.
The 2024 National Health Care Fraud Enforcement Action has resulted in criminal charges being filed against 193 defendants, including 76 doctors, nurses, and other licensed medical professionals in 32 federal districts across the country. $231 million in cash, gold, luxury vehicles, and other assets has been seized.
One of the actions announced by HHS-OIG Inspector General Christi A. Grimm involved five individuals at a start-up telehealth company that claimed they diagnosed and treated attention deficit hyperactivity disorder (ADHD). The company engaged in deceptive advertising on social media networks to target patients, who were prescribed addictive drugs such as Adderall and other stimulants when they were not medically necessary. Millions of pills were prescribed through the telehealth company, Done Global Inc. and its affiliated entity, Done Health P.C.
The CEO and Clinical President were charged on June 13, and the charges were announced on June 27. One of the most prolific prescribers was a Florida nurse practitioner who prescribed more than 1.5 million Adderall pills and other stimulants to patients across the United States. The auto-refill policy of Done meant patients continued to receive prescriptions without any further interactions with the patients, including some patients who continued to be prescribed the pills months after overdose deaths.
HHS OIG Exclusions List
What You Need To Know
Get The 6 Essentials Checklist For Compliance Officers
A link to your download will be sent to your email address
Your Privacy Respected
HIPAA Journal Privacy Policy
In another action, 4 arrests were made in connection with $900 million in false and fraudulent Medicare claims for amniotic wound grafts. These expensive, medically unnecessary treatments were often given to elderly patients, including terminally ill patients in hospice care. Other highlights include charges in connection with $1.1 billion in telemedicine and laboratory fraud, $146 million in fraudulent addiction treatment schemes, a $90 million fraud scheme that distributed adulterated and misbranded HIV medications, and more than $450 million in other healthcare fraud and opioid schemes.
“We will not tolerate fraud that preys on patients who need and deserve high quality health care,” said the Grimm. “The hard work of the HHS-OIG team and our outstanding law enforcement partners makes today’s action possible. We must protect taxpayer dollars and keep Americans safe from harms to their health, privacy, and financial well-being.”
