Feds Charge 15 in Los Angeles Health Care Fraud Cases With $2 Billion in Alleged Losses

The Justice Department charged 15 defendants, including six medical professionals, in Los Angeles-area health care fraud cases with $2 billion in alleged losses, the Drug Enforcement Administration announced Thursday. Eight of the defendants, some of them physicians, were arrested by federal agents on Thursday, and most of the arrests took place in California, ABC News reports.

The alleged schemes billed private insurers for phony substance abuse treatment, billed Medicare for unnecessary atherectomy procedures, and charged Medicare for hospice care for patients who were not terminally ill, the department said. Atherectomies remove plaque from blood vessels, ABC News reports.

The biggest case centers on two people in Los Angeles and one in Texas, according to the Justice Department. Prosecutors allege they spent years moving substance abuse patients from around the country to California, enrolled them in insurance policies they were not eligible for, and collected the highest reimbursement rates for treatment. The department says they took in more than $1.6 billion. Law360 reports prosecutors called it the largest substance abuse treatment fraud ever prosecuted by the federal government.

In a separate case, a Los Angeles cardiothoracic surgeon and a chiropractor are accused of falsely diagnosing patients with arterial disease and recommending atherectomies, the Justice Department said. The department alleges they billed Medicare more than $135 million for the procedures.

Three more cases involve hospice fraud, according to the department. Prosecutors allege the defendants in those cases billed Medicare a combined $138 million for hospice services for patients who were not terminally ill.