Industrial Opioid Disaster – Federal Health Care Fraud Takedown In Northeastern U.S.
New Jersey Strong news – Newark, NJ: US Dept of Justice NJ reports 9.27.2019
Additional New Jersey Case Announced
The Justice Department today announced a coordinated health care fraud enforcement action across seven federal districts in the Northeastern United States, involving more than $800 million in losses and the distribution of over 3.25 million pills of opioids in “pill mill” clinics and doctors’ offices. The takedown includes new charges and convictions by guilty plea against 54 defendants for their roles in submitting nearly $800 million in fraudulent claims made to federal payers, including 15 doctors or medical professionals, and 24 defendants are charged for their roles in diverting opioids.
Attorney for the United States Rachael A. Honig said the cases prosecuted by this Office in connection with the takedown reflect all of the different facets of the office’s health care and opioids work. Doctors, marketing executives, pharmacists, and the owners and operators of a genetic testing laboratory have been charged with, or have plead guilty to a range of criminal conduct, including: the criminal prescription of highly-addictive opioid pills to patients with no medical need, the paying of kickbacks and other fraud related to unnecessary genetic testing, fraud and abuse in the compounded medicines business, and other crimes that victimize federal health care programs like Medicare and Medicaid, as well as patients across New Jersey who need medical care.
Today’s enforcement actions were led and coordinated by the Health Care Fraud Unit of the Criminal Division’s Fraud Section in conjunction with its Medicare Fraud Strike Force (MFSF), as well as the U.S. Attorney’s Offices for the District of New Jersey, Eastern District of Pennsylvania, Western District of Pennsylvania, Eastern District of New York, Western District of New York, District of Connecticut, and District of Columbia. The MFSF is a partnership among the Criminal Division, U.S. Attorney’s Offices, the FBI and HHS-OIG. In addition, IRS-Criminal Investigation, DOD-DCIS, FDA-OIG, the Medicaid Fraud Control Unit, and other federal and state law enforcement agencies participated in the operation.
The charges involve individuals contributing to the opioid epidemic, including medical professionals involved in the unlawful distribution of opioids and other prescription narcotics, a particular focus for the Department. According to the Centers for Disease Control, approximately 115 Americans die every day of an opioid-related overdose.
Today’s arrests and guilty pleas come one-year after the Department of Justice announced the formation of the Newark/Philadelphia Regional MFSF, a joint law enforcement effort that brings together the resources and expertise of the Health Care Fraud Unit in the Criminal Division’s Fraud Section, the U.S. Attorney’s Offices for the District of New Jersey and the Eastern District of Pennsylvania, as well as law enforcement partners. The Strike Force focuses its efforts on aggressively investigating and prosecuting complex cases involving patient harm, large financial loss, and the illegal prescribing and distribution of opioids and other dangerous narcotics.
“Physicians and other medical professionals who fraudulently bill our federal health care programs are stealing from taxpayers and robbing vulnerable patients of necessary medical care. The medical professionals and others engaging in criminal behavior by peddling opioids for profit continue to fuel our nation’s drug crisis,” said Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division. “The Department of Justice will continue to use every tool at our disposal, including data analytics and traditional law enforcement techniques, to investigate, prosecute, and punish this reprehensible behavior and protect federal programs from abuse.”
“The FBI does not care about your status in life, your professional standing, your level of income, or your personal connections when you break the law,” Assistant Special Agent in Charge Wayne Jacobs of the FBI’s Newark Field Office said. “If you try to scam the system, if you exploit your professional license just to pad your pockets, if you mortgage your morals just to inflate your bank account, you will only find yourself in deeper debt. We are committed to protecting the public; we are intent on rooting out fraud and corruption; we are duty-bound to track down and arrest anyone who is breaking our federal laws. Don’t be next.”
Among those charged in the District of New Jersey are the following:
- Aaron Williamsky 59, of Marlboro, New Jersey, and Nadia Levit, 40, of Englishtown, New Jersey, owners of approximately 25 durable medical equipment companies, pleaded guilty on Sept. 18 and Sept. 25, respectively, for their participation in a health care fraud scheme related to their payment of kickbacks in exchange for doctors’ orders for medically unnecessary orthotic braces. Levit’s conduct admittedly caused losses in excess of $120 million and Williamsky’s conduct admittedly caused losses in excess of $170 million. Williamsky also pleaded guilty to a money laundering conspiracy related to his attempt to conceal at least $1.65 million of the proceeds of the fraud. The case was investigated by FBI, HHS-OIG, IRS-CI and special agents of the U.S. Attorney’s Office. The case is being prosecuted by Assistant U.S. Attorneys J. Stephen Ferketic and Sean Sherman and of the District of New Jersey.
The Fraud Section leads the Medicare Fraud Strike Force. Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.
A complaint, information or indictment is merely an accusation, and all defendants are presumed innocent until and until proven guilty.