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Attorney General Announces Eighth Annual Fraud Takedown Targeting Opioid Epidemic

On July 13, 2017, Attorney General Jeff Sessions and the Department of Health and Human Services (HHS) Secretary Tom Price, M.D., announced the eighth year of the federal health care fraud takedown. This year, the federal government’s main target was the nation’s rising opioid epidemic. In connection with the announcement, the Office of the Inspector General (OIG) released a report regarding opioid waste, fraud and abuse in the federal health care programs. The federal crackdown focuses primarily on opioid treatment centers that are alleged to have submitted false or fraudulent claim to health insurers.

Attorney General Sessions’ press conference described this joint effort with HHS OIG as “the largest health care fraud takedown in history.” The Medicare Fraud Strike Force charged 412 defendants across 41 federal districts with defrauding the federal government of a total of $1.3 billion. The defendants include 115 licensed health care professionals who are alleged to have participated in various health care fraud schemes. Thirty state Medicaid Fraud Control Units also participated in the arrests. In addition, HHS served exclusion notices on 295 health care providers for opioid diversion and abuse.  Among those issued exclusion notices were 57 doctors, 162 nurses and 36 pharmacists.

According to Attorney General Sessions, today’s arrests are just the beginning of efforts and charges will continue to be brought in an effort to curb the growing opioid epidemic. In addition to the Strike Force, the enforcement actions include investigations and cases brought by 31 U.S. Attorney’s Offices. In the Southern District of Ohio, five defendants, including four physicians, were charged in connection with schemes involving $12 million in claims to the Medicaid program. Search warrants have also been issued to health care providers after investigation by the Northern District of Ohio. 

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About this Author

Jennifer Mitchell, health care practice group partner, Dinsmore Shohl, law firm,
Partner

Jennifer is a Partner in the Health Care Practice Group and leads the firm’s HIPAA Privacy and Security practice and initiatives. In her HIPAA practice, she works with clients to minimize the risk of privacy and data security issues, assisting with all aspects of HIPAA privacy and security compliance, governance, audits/investigations, breach analyses, training and strategic planning. She has a thorough understanding of federal and state privacy and confidentiality laws and has served as a health care privacy expert witness. 

Within the...

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Matthew Arend, Litigation Attorney, Dinsmore Law Firm, privacy, data security
Partner

Matt is a member of the Health Care Practice Group, focusing his practice on all aspects of federal and state privacy and data security issues, including HIPAA compliance, breach analyses, and governance. He also routinely advises clients on compliance with federal and state anti-kickback laws, Stark law, Sunshine Act, Medicare Secondary Payer laws, pharmaceutical marketing rules and other regulatory matters. Additionally, his thorough knowledge of the healthcare arena enables him to counsel clients through audits and investigations, as well as providing training and strategic planning counseling. 

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Jenna Moran, Corporate Attorney, Dinsmore Law Firm
Associate

Jenna is a member of the Corporate Department, focusing her practice on health care law. Prior to joining Dinsmore, she served as a judicial extern for Judge Raymond Mitchell in the Circuit Court of Cook County in Chicago. She also worked as a law clerk for Krieg DeVault, LLP in Chicago where she gained experience in regulatory compliance, pharmacy law, Medicare/Medicaid appeals and reimbursement, and health law litigation. Jenna also served as the Symposium Editor for the DePaul Law Review, where she organized the 24th annual DePaul Law Review Symposium bringing...

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