25 face Federal charges in alleged fraud scheme

On Wednesday September 18th, the U.S. Attorney’s Office for Central California announced charges against 25 entities, including 24 individuals and a pharmaceutical company for an alleged scheme to defraud Medicare, Medicaid, and private insurers and union health plans out of over $150 million. According to the statement, the charges “target schemes billing Medicare, Medicaid and other health care plans for services, testing and prescriptions that were not medically necessary or not actually provided to beneficiaries.” The defendants include professionals ranging from chiropractors and pharmacists to hospice owners and marketers. One of the defendants is alleged to have participated in conspiring in a scheme involving kickbacks for pharmaceuticals involving New Age Pharmaceuticals, Inc. in Beverly Hills. New Age Pharmaceuticals’ owner had previously been charged in 2016 as part of a scheme that generated almost $1 billion in fraudulent billings targeting government programs, including the California workers’ compensation system. The new Medicare charges could result in their suspension within workers’ compensation. It is not yet evident if any of the allegations include defrauding workers’ compensation carriers.