DOJ touts huge fraud takedowns in Texas, nationally during 2018

A wealth of empirical data underscores the sharp degree to which federal regulators and law enforcers are focused upon government-directed fraud.

And what is especially notable about that laser-like attention is just how specifically it targets alleged criminal wrongdoing in the health care sphere.

Consider this: Reportedly, about 90% of all money recovered by the U.S. Department of Justice last year under the federal False Claims Act related to fraud probes in the health care arena.

Indeed, American’s medical providers – ranging from doctors, nurses and service billers to medical device makers, drug manufacturers, pharmacists and more – are seemingly under a regulatory microscope when it comes to fraud investigations.

The close scrutiny from the DOJ and other agencies is not only intense, but ongoing as well. Federal officials say that the $2 billion-plus in fraud-linked recoveries from health care actors during 2018 was preceded by settlements bringing in just as much for eight years in a row prior to that.

In other words, last year not an anomaly but, rather, further evidence of a long-entrenched trend.

The list of alleged misconduct is both lengthy and varied. It includes these asserted wrongs:

  • Unlawful drug repackaging enabling more drugs to be sold to cancer patients
  • Sales of unreliable diagnostic equipment
  • Manipulation of patients’ records to allow for increased billing
  • Improper prescribing and distribution of opioid medications

Texas was far from excepted in the DOJ’s compendium of asserted crimes. We noted in a July 10 blog post from last year that a state pharmacy owner and additional parties were charged “with the unlawful filling of opioid prescriptions that ended up in the hands of drugs couriers and dealers.” Their prosecution was a fragmentary piece in what the DOJ termed the largest health care fraud sting operation in history.

Alleged health care wrongdoing that comes to light via whistleblower actions or otherwise will unquestionably continue to be a top-tier focus for law enforcers and government regulators. Questions or concerns regarding this singular legal realm can be addressed to a criminal defense firm with a demonstrated record of strong advocacy on behalf of individuals and entities charged with white collar crimes.