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September 23, 2021

DOJ Announces Criminal Charges Alleging $1.4B in Losses Attributable to National Health Care Fraud Scheme

On September 17,  DOJ announced , an enforcement action alleging $1.4 billion in losses to federal health care programs. In the announcement, DOJ brought forward four separate health care fraud theories underpinning charges against over 138 defendants, which includes forty-two (42) physicians, nurses, and other licensed medical professionals. The allegations include fraud theories related to telemedicine, substance abuse centers or “sober homes,” COVID-19 services, and misuse of federal pandemic relief funds, illegal prescription and/or distribution of opioids, and other traditional health care fraud schemes. Most notably, the government asserted that telemedicine fraud resulted in over $1.1B of the allegedly false and fraudulent claims submitted by forty-three (43) criminal defendants in eleven (11) judicial districts.