Nearly 50 people, including 18 medical professionals, have been charged in the Southern District of Texas as part of a nationwide crackdown on healthcare fraud.
The announcement alleges a huge spectrum of healthcare fraud crimes, including doctors and nurses prescribing millions of opioid pills for cash, hospice companies billing for patients who weren’t actually dying, and clinics scamming Medicare with bogus genetic tests and equipment.
In total, prosecutors say nearly 12 million pills were illegally distributed and more than $360 million was fraudulently billed to Medicare, threatening the ability of honest and legal taxpayers to get the medication or care they need.
“Americans rely on Medicare for needed treatments and living-saving care. Those that bilk this fund to unlawfully enrich themselves are ultimately stealing from the taxpayer and damaging public confidence in our health system,” said U.S. Attorney Nicholas Ganjei in the announcement.
Among the largest cases recently listed is a $110 million hospice scheme allegedly led by Richmond, Texas residents, Dera Ogudo and Victoria Martinez. Their company, United Palliative & Hospice Care, is accused of enrolling elderly patients in hospice care without their knowledge, or without them being terminally ill whatsoever, an obvious requirement for Medicare coverage.
Prosecutors also say they bribed doctors and group home operators to keep the scam going.
In another case, a Houston-based ring allegedly pumped out over two million opioid pills using doctors’ “prescribing credentials.” Keilan Peterson, known as “Young Jay,” and Kimberly Martinez are accused of paying doctors to let them use their electronic prescription systems to push massive amounts of hydrocodone, oxycodone, and other highly addictive prescription drugs.
Now, prosecutors claim that many of those pills ended up on the black market.
Other schemes included fraudulent COVID-19 testing reimbursements, mental health therapy scams, and fake wound care treatments that billed Medicare for services patients never received or needed.
The charges across South Texas are part of a nationwide takedown involving 324 defendants accused of more than $14 billion in intended fraud losses, as well as “illegal diversion” of over 15 million pills.
Federal agents have claimed to have seized more than $245 million in cash, luxury cars, and other assets connected to the recently announced fraud cases.
Attorney General Pamela Bondi spoke on how these crackdowns on healthcare fraud protect vulnerable patients and apparently restore confidence in the system for taxpayers.
“This record-setting health care fraud takedown delivers justice to criminal actors who prey upon our most vulnerable citizens and steal from hardworking American taxpayers,” Bondi said. “Make no mistake – this administration will not tolerate criminals who line their pockets with taxpayer dollars while endangering the health and safety of our communities.”
Those recently charged in the healthcare fraud cases in Southern Texas span across Houston, Richmond, Katy, Sugar Land, and beyond.