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New Medicare Fraud Strike Force Is Formed

As many of the Allegiant Experts blog posts have highlighted, there has been a major crackdown on Medicare fraud over the past year. With thousands of charges against perpetrators of health care fraud to speak of, the crackdown is a result of the formation of Medicare fraud strike forces all over the country.

As Beth Jones Sanborn reports for Healthcare Finance, the ten strike forces currently in operation have charged over 3,700 defendants who collectively have falsely billed the Medicare program for over $14 billion. Those ten strike forces exist in Miami, Florida; Los Angeles, California; Detroit, Michigan; Houston, Texas; Brooklyn, New York; Baton Rouge and New Orleans, Louisiana; Tampa, Florida; Chicago, Illinois; and Dallas, Texas.

The corporate strike force is located in Washington, D.C.

According to Sanborn’s report the Department of Justice has announced an eleventh regional Medicare fraud strike force for the Newark, New Jersey and Philadelphia, Pennsylvania region. The new force will be known as the Newark/Philadelphia Regional Medicare Fraud Strike Force.

One of the main objectives of the new Newark/Philadelphia strike force is to continue the crackdown on the nation’s opioid crisis. “The illegal prescription and distribution of opioids has been a frequent theme in healthcare frauds over the last few years, as the opioid epidemic ramped up across the U.S.,” writes Sanborn.

“The strike force will focus its efforts on aggressively investigating and prosecuting cases involving fraud, waste, and abuse within our federal health care programs, and cases involving illegal prescribing and distribution of opioids and other dangerous narcotics,” the Department Of Justice wrote in a statement.

Medicare strike forces have resulted in historic arrests.

Sanborn reminds us that this past June, the largest ever healthcare fraud takedown in history took place. We blogged about this monumental happening in July. No less than 601 defendants were charged across 58 federal districts, including 165 doctors, nurses and other licensed medical professionals. They were each accused of participating in health care fraud schemes that racked up over $2 billion in false billings.

“Of those charged, there were 162 defendants charged for their roles in prescribing and distributing opioids and other dangerous narcotics and 76 of them were doctors,” Sanborn reports. Also in June, a CEO and four physicians from Michigan and Ohio were charged in a massive $200 million fraud scheme that involved a network of Michigan and Ohio pain clinics, laboratories and other medical providers.

This past April, a former hospital CEO and two physician leaders were indicted on charges related to an alleged pill mill operation they operated from the hospital. As part of Operation SCOPE, federal charges were brought against John Michael Gowder and physicians, David Gowder and James Heaton. They were charged with illegally prescribing and obtaining thousands of prescription pain medications.

Among the drugs the Gowders illegally obtained were oxycodone, hydrocodone and alprazolam, the latter of which is commonly sold under the brand name, Xanax. And last December, “a Pennsylvania physician was indicted on charges he operated a ‘pill mill’ that improperly distributed millions of narcotic painkillers, ultimately leading to the deaths of five patients,” reports Sanborn, “He now faces multiple life sentences in prison.”

Are you an attorney working a health care fraud case?

If so, please don’t hesitate to reach out to Allegiant Experts to find out how we can help you. Call us at 407-217-5831 or email us at

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