The Justice Department announced criminal charges against nearly 200 people Thursday in a nationwide crackdown on health care fraud schemes and falls claims totaling $2.7 billion in intended losses.
Doctors, nurse practitioners, and other licensed medical professionals across the U.S. are accused of various schemes, including a $900 million scam in Arizona that targeted terminally ill 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; if you profit from the unlawful distribution of controlled substances, you will be held accountable,” Attorney General Merrick Garland said in a statement.
In the Arizona case, Alexandra Gehrke, 38, and Jeffrey King, 49, owners of several wound-care companies, were charged with various counts of conspiracy, health care fraud, receiving kickbacks, and money laundering in an alleged scheme to bill hundreds of millions of dollars for expensive amniotic grafts, which are dressings to help heal wounds.
Nurse practitioners were allegedly pressured to apply wound grafts to elderly patients who did not need them, including some who were in hospice care, according to the DOJ. Some of the patients who received the grafts died on the same day or within days, according to the 21-page indictment.
Between November 2022 and May 2024, the pair is accused of submitting more than $900 million in bogus claims to Medicare for grafts that were not medically necessary.
“Medicare and other health benefit programs paid over $600 million based on these false claims to Medicare for these medically unnecessary allografts applied to less than approximately 500 patients,” court documents stated.
In addition, they allegedly received more than $330 million in illegal kickbacks from the graft distributor in exchange for their orders, according to the DOJ.
Ms. Gehrke and Mr. King, who got married earlier this year, 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.
Authorities allege Gehrke and King knew charges were coming and had been planning to flee the country.
Authorities said they found a book in the couple’s home titled “How To Disappear: Erase Your Digital Footprint, Leave False Trails, and Vanish Without a Trace,” according to court papers. One of their bags packed for their flight contained was a book titled “Criminal Law Handbook: Know Your Rights, Survive The System,” court documents say.
Prosecutors allege the couple lived lavishly off the scheme, with court papers 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.
The DOJ said 193 people were charged in a series of separate cases brought over about two weeks in the nationwide healthcare fraud sweep, “involving 2.75 billion in intended losses and $1.6 billion in actual losses.”
Authorities seized more than $230 million in cash, luxury cars, and other assets.
Another Arizona case involves a 52-year-old woman and a $69 million scheme involving a substance abuse treatment clinic. Rita Anagho allegedly billed the state’s Medicaid agency for substance abuse treatment services that served no purpose or were never provided, prosecutors said.
In Florida, prosecutors said three men ran a scheme to distribute misbranded HIV drugs.
Adam Brosius, 59, Patrick Boyd, 43, and Charles Boyd, 46, allegedly purchased drugs on the black market and resold them to unsuspecting pharmacies, which then dispensed the medications to patients.
“At times, patients received bottles labeled as their prescription medication, but the bottles contained a different drug entirely, with one patient passing out and remaining unconscious for 24 hours after taking an anti-psychotic drug, thinking it was his prescribed HIV medication,” according to the DOJ.
From The Epoch Times