Justice Department Charges Nearly 200 People in $2.7 Billion Health Care Fraud Schemes Crackdown

By Associated Press

Published 1 year ago on

June 27, 2024

Nationwide crackdown by Justice Department charges nearly 200, including medical professionals, in $2.7 billion health care fraud schemes. (AP/Jose Luis Magana)

Getting your Trinity Audio player ready...

WASHINGTON — Nearly 200 people have been charged in a sweeping nationwide crackdown on health care fraud schemes with false claims topping $2.7 billion, the Justice Department said on Thursday.

Attorney General Merrick Garland announced the charges against doctors, nurse practitioners and others across the U.S. accused of a variety of scams, including a $900 million scheme in Arizona targeting dying patients.

“It does not matter if you are a trafficker in a drug cartel or a corporate executive or medical professional employed by a health care company,” Garland told reporters. “If you profit from the unlawful distribution of controlled substances, you will be held accountable.”

Arizona Case: Fraudulent Billing of Medicare

In the Arizona case, prosecutors have accused two owners of wound care companies of accepting more than $330 million in kickbacks as part of a scheme to fraudulently bill Medicare for amniotic wound grafts, which are dressings to help heal wounds.

Nurse practitioners were pressured to apply the wound grafts to elderly patients who didn’t need them, including people in hospice care, the Justice Department said. Some patients died the day they received the grafts or within days, court papers say.

In less than two years, more than $900 million in bogus claims were submitted to Medicare for grafts that were used on fewer than 500 patients, prosecutors said.

Owners of Wound Care Companies Arrested

The owners of the wound care companies, Alexandra Gehrke and Jeffrey King, were arrested this month at the Phoenix airport as they were boarding a flight to London, according to court papers urging a judge to keep them behind bars while they await trial. An attorney for Gehrke declined to comment, and a lawyer for King didn’t immediately respond to an email from The Associated Press.

Authorities allege Gehrke and King, who got married this year, knew charges were coming and had been preparing to flee. At their home, authorities found a book titled “How To Disappear: Erase Your Digital Footprint, Leave False Trails, and Vanish Without a Trace,” according to court papers. In one of their bags packed for their flight, there was a book titled “Criminal Law Handbook: Know Your Rights, Survive The System,” the papers say.

Gehrke and King lived lavishly off the scheme, prosecutors allege, citing luxury cars, a nearly $6 million home and more than $520,000 in gold bars, coins and jewelry. Officials seized more than $52 million from Gehrke’s personal and business bank accounts after her arrest, prosecutors say.

Health Care Fraud Sweep

In total, 193 people — including 76 doctors, nurse practitioners, and other licensed medical professionals — were charged in a series of separate cases brought over about two weeks in the nationwide health care fraud sweep. Authorities seized more than $230 million in cash, luxury cars and other assets. The Justice Department carries out these sweeping health care fraud efforts periodically to help deter other potential wrongdoers.

In another scheme targeting Native Americans, phony sober living homes were set up promising addiction treatment. Claims were then submitted for services that were never actually performed, officials said.

Another case alleges a scheme in Florida to distribute misbranded HIV drugs. Prosecutors say drugs were bought on the black market and resold to unsuspecting pharmacies, which then provided the medications to patients.

Some patients were given bottles that contained different drugs than the label showed. One patient ended up unconscious for 24 hours after taking what he was led to believe was his HIV medication but was actually an anti-psychotic drug, prosecutors say.