With a little over two weeks left in the year, many of us having been talking about “wrap ups” and “best of” lists. However, because we’re about to embark on a brand new decade, these lists of recollections include memories from the past ten years and not just the past twelve months.

The past decade saw the biggest health care fraud takedown in U.S. history.

At Allegiant Experts, we’re pleased to note that the past decade has seen quite a surge in health care fraud perpetrators being brought to justice. Most notably, back in June of 2018, the United States Justice Department charged more than 600 people, including 165 doctors and other medical professionals, with making $2 billion in false billings. It was deemed the nation’s largest ever health care fraud takedown by at-the-time Attorney General Jeff Sessions.

As reported by Sari Horowitz of The Washington Post, the cases were connected to the nation’s ongoing opioid crisis. In 2016, it killed nearly 64,000 people. “It is the deadliest drug epidemic in the history of this country,” Sessions was quoted as saying at a news conference, “We have never seen anything like it. Some of our most trusted medical professionals look at their patients, vulnerable people suffering from addiction, and they see dollar signs.”

There is still much work to be done.

Clearly, not all health care fraudsters have been brought to justice. As our weekly blogs make clear, medical professionals of all kinds continue to abuse our nation’s insurance programs for profit. In fact, the Office of Inspector General reports that there are over 170 people on its Most Wanted Fugitives list.

Among them is Angel Lagoa. “In January 2017, Angel Lagoa was indicted on charges of conspiracy to commit healthcare fraud and wire fraud,” the OIG reports, “Investigators believe that, from 2010 to 2015, Lagoa and his co-conspirators submitted approximately $30 million in false or fraudulent claims to Medicare.” Lagoa is currently ranked #1 on the OIG’s Most Wanted Fugitives list. Investigators believe he is currently residing in Cuba.

Maria Moreira is the lone woman among the OIG’s top ten most wanted fugitives.

Along with her husband, Miguel Angel Hernandez, Maria Del Pilar Moreira was indicted on charges of conspiracy and healthcare fraud in November of 2014. Investigators believe that the couple submitted nearly $7 million in false claims to Medicare. While the owners of East Point Medical Center and Family First Medical Center in Georgia, Hernandez and Moreira submitted false claims to Medicare and Medicaid for medical services that were either medically unnecessary or not provided.

“They also billed for expensive trigger point injections (for which Medicare pays between $58 and $60) when, in fact, they actually provided vitamin B-12 shots (for which Medicare pays around $0.66),” reports the OIG, “In addition, the couple billed for medical services on days when they actually drove patients to restaurants for parties.”  Investigators believe the couple is currently residing in Spain.

Are you an attorney who is currently trying a health care fraud case?

Please don’t hesitate to contact Allegiant Experts to find out how our clinical expertise may help your case. Give us a call at 407-217-5831 or email us at info@allegiantexperts.com.

Please make note of our holiday hours. We will close on the 20th of December and not reopen until January 6th.