WASHINGTON (AP) — The Justice Department announced Thursday that nearly 200 people have been indicted in a sweeping nationwide crackdown on health insurance fraud schemes involving false claims totaling more than $2.7 billion.
Attorney General Merrick Garland announced charges against doctors, nurses and others across the country for participating in a variety of fraud schemes, including a $900 million scam targeting dying patients in Arizona.
“Whether you're a drug cartel trafficker, a corporate executive or a medical professional employed by a health care company, if you profit from the illegal distribution of controlled substances, you will be held accountable,” Garland said in a statement.
In the Arizona case, prosecutors have accused two owners of a wound-care company of accepting more than $330 million in bribes as part of a scheme to fraudulently bill Medicare for amniotic membrane wound grafts, a dressing that helps wounds heal.
The Justice Department said nurses were pressured to perform wound grafts on elderly patients who didn't need them, including those receiving hospice care. Some patients died the same day or within days of receiving the transplants, according to court documents.
In just under two years, prosecutors say, more than $900 million in false claims were submitted to Medicare for transplant procedures used on fewer than 500 patients.
Wound-care company owners Alexandra Gerke and Jeffrey King were arrested at Phoenix airport this month while boarding a flight to London. Court documents say a judge is asking that they be held in custody while they await trial. Gerke's lawyer declined to comment, and King's lawyer did not immediately respond to an email from The Associated Press.
Authorities allege that Goerke and King, who married this year, knew they would be indicted and were making preparations to flee. According to court documents, authorities found a book in their home titled “How to Disappear: How to Erase Your Digital Tracks, Leave False Trails, and Disappear Without a Trace.” One of the bags they packed for their escape contained a book titled “Criminal Law Handbook: Know Your Rights and Survive the System,” the documents state.
Prosecutors allege that Goerke and King lived a lavish lifestyle during the scheme, with court documents listing luxury vehicles, a nearly $6 million home and more than $520,000 in gold bars, coins and jewelry. After their arrests, authorities seized more than $52 million from Goerke's personal and business bank accounts, prosecutors said.
A total of 193 people were indicted in a series of separate cases brought over a roughly two-week period in the nationwide health care fraud investigation. Authorities seized more than $230 million in cash, luxury vehicles and other assets. The Department of Justice routinely conducts such large-scale health care fraud investigations in an effort to deter other potential fraudsters.
In another Arizona case, a woman is accused of billing the state's Medicaid agency for substance abuse treatment services that didn't actually serve any purpose or were never provided, prosecutors said.
In another case, prosecutors allegedly schemed to distribute counterfeit HIV medications in Florida, where the drugs were purchased on the black market and resold to unsuspecting pharmacies, which then provided them to patients.
In some cases, bottles given to patients contained different drugs than those indicated on the label: One patient was rendered unconscious for 24 hours after taking what he believed to be an HIV treatment, but was actually an antipsychotic, prosecutors said.
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Alanna Durkin Richer, The Associated Press
