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The Department of Justice (DOJ) announced sweeping charges Monday against more than 300 defendants, alleging they misled patients into paying for, and sometimes receiving, medical care that they did not need.
In turn, DOJ Criminal Division chief Matthew Galeotti said, the defendants also attempted to swindle Medicare and other taxpayer-funded and private health insurance programs out of about $14.6 billion.
The announcement marked the “largest coordinated healthcare fraud takedown in the history of the Department of Justice,” Galeotti said during a press conference.
One set of charges included, for example, an indictment against three defendants in Arizona who allegedly conspired to purchase and give elderly Medicare recipients skin grafts known as “amniotic wound allografts.” The defendants allegedly reaped millions of dollars from the practice.
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One of the defendants, a nurse practitioner, applied the grafts to patients even though they were “medically unreasonable and unnecessary,” the indictment said. The nurse allegedly applied them to terminally ill patients in hospice, including some who were days away from dying.
While that specific medical practice is typically non-invasive, Galeotti noted it was part of a $1 billion healthcare fraud scheme that stripped patients of “dignity and peace” in their final days.
“That conduct is exactly as callous and disturbing as it sounds,” Galeotti said. “Patients and their families trusted these providers with their lives. Instead of receiving care, they became victims of elaborate criminal schemes.”
One DOJ official said in response to a question from Fox News Digital that skin grafts were an “emerging area” of healthcare fraud, “especially given the significant amount of money that they can bill for sometimes in excess of $1,000 a square centimeter.”
The healthcare fraud cases, all of which were shared publicly online, spanned the country and globe. Defendants included medical supply company owners and medical professionals, including 25 doctors.
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An FBI official announced at the press conference that one scheme, called “Operation Gold Rush,” resulted in at least 20 members of a transnational criminal organization, including defendants based in Russia, being charged as part of a $10 billion Medicare and money laundering operation that centered on catheters.
The DOJ Criminal Division’s healthcare fraud unit led the effort. Galeotti said Monday the DOJ also launched a “fusion center” in which it would join forces with other agencies to consolidate healthcare data as part of its investigations into fraud.
Galeotti and Dr. Mehmet Oz, Centers for Medicare and Medicaid Services administrator, also used the press conference to make a plea for more tips.
“We need your help, the American people,” Oz said. “Why? Over half of the whistleblower tips that we get are for healthcare fraud and over half of the fraud against our government is in healthcare.”
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