Feds: Suspects in nation's largest healthcare crackdown contributed to opioid crisis

Doctors were billing insurance companies for procedures they didn't perform.

JACKSONVILLE, Fla. - The federal government is cracking down on what’s being described as the largest healthcare fraud in the U.S. It has led to hundreds of arrests, most of them doctors and other medical professionals who are accused of stealing a total of $1.3 billion of taxpayer money.

Those arrested are accused of billing Medicare, Medicaid and TRICARE for medically unnecessary prescription drugs, as well as procedures that were never performed.

The takedown covered 41 districts and netted 412 arrests, 115 doctors, nurses and other licensed medical professionals were all charged.

Ten individuals in the Middle District, which covers Jacksonville to Tampa, were charged with participating in a variety of schemes involving almost $14 million in fraudulent billing.

In one case, three defendants were charged in a $4 million scheme to defraud the TRICARE program.

In that case, it is alleged that a defendant falsely represented himself to be a retired lieutenant commander of the U.S. Navy Submarine Service. It is alleged that he did so in order to gain the trust and personal identifying information from TRICARE beneficiaries, many of whom were members and veterans of the armed forces, for use in the scheme.

The Centers for Disease Control and Prevention reports approximately 91 Americans die daily from an opioid overdose. Federal investigators said some of the suspects in this fraud case contributed to the crisis.
Jack Gehring was arrested for trafficking prescription opioids, primarily oxycodone. Prosecutors said Gehring and family members created a network to obtain the pills, in order to illegally distribute them at black market prices of $20 per pill or more.
 
Michael Rotstein, a podiatrist in Ocala, was arrested for fraud. He has pled guilty to billing the government of $1.5 million. He billed Medicaid, Medicare and TRICARE for procedures he never performed.

Larry Howard, a Central Florida pharmacist, is facing charges of conspiracy to pay and receive illegal kickbacks.
Dr. Nicole Bramwell and Patient Recruiter Raymond Stone were part of the scheme, which targeted military families in the TRICARE program.
   
Richard Martin, a former pharmaceutical sales representative, was arrested for conspiracy to commit health care fraud. Prosecutors said Martin filed phony bills with the Medicare Part B program, which resulted in double-billing.

On Your Side Tip: You should always review your Explanation of Benefits (EOB) statement and if you see suspicious charges contact your health care provider immediately.
 

© 2017 WTLV-TV


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