Pill bottles and money representing medicare fraud.

Federal Government Uncovers $150 Million Medicare Fraud Scheme

A federal jury recently found four Michigan physicians guilty of Medicare fraud for their roles in a scheme that involved administering unnecessary treatments to patients in exchange for medically unnecessary prescriptions. The doctors required patients to receive the injections in order to get the prescriptions, and some of these were resold on the street by drug dealers. After a trial that lasted four weeks, each of the four doctors was found guilty of one count of conspiracy to commit health care fraud and one count of healthcare fraud.

From 2008 to 2016, the doctors worked at several medical clinics in Michigan and Ohio, where they engaged in a scheme to defraud Medicare for over $150 million. Specifically, the doctors billed for medically unnecessary drug screens, facet joint injections, unnecessary urinary drug screens, and several other unnecessary ancillary services. The patients, who included people suffering from legitimate pain, opioid addicts, and drug dealers, were offered oxycodone prescriptions by the doctors in exchange for these unnecessary treatments. 

Regarding the injections, it was established at trial that the doctors repeatedly performed unnecessary facet joint injections on patients, and they were paid more for these treatments than any other medical clinic in the United States. In fact, the defendants were ranked among the highest-paid doctors for facet joint injections, despite only working a few hours each week. Specifically, the doctors earned anywhere from $1,100 to $3,500 an hour for performing these unnecessary injections.

In addition to the facet joint injections, the defendants required their patients to take urine tests that resulted in tens of thousands of dollars in illegal kickbacks. Further, the physicians performed a test for 56 different drugs for each patient at each visit regardless of necessity. And as noted above, the doctors provided patients with high-dosage prescriptions for narcotics as an incentive to consent to the facet joint injections.  

The case was investigated and prosecuted by the Medicare Fraud Strike Force. Since its inception, the Medicare Fraud Strike Force has charged over 4000 defendants for fraudulent claims totaling nearly $20 billion. 

Contact a Medicare fraud whistleblower attorney  

When you report Medicare fraud, you perform a valuable service to the federal government, taxpayers, and Medicare recipients. In addition, if the government decides to pursue a case based on the information you provide, you may be entitled to significant financial compensation. Therefore, if you have information that may lead to the recovery of fraudulently obtained Medicare funds, you should contact a Medicare fraud whistleblower attorney for assistance. At Jeffrey Newman Law, we’ll vigorously pursue your Medicare fraud whistleblower claim in a manner that offers you the full protection of the law. In addition, we’ll utilize our vast experience to pursue financial compensation on your behalf, working our hardest to increase your chances of a significant reward. Please contact us today for a consultation.