The US Justice Department announced Monday it has prevented the embezzlement of more than $11 billion in federal funds through health insurance fraud schemes since the beginning of the year.
The crackdown has led to criminal charges against 324 individuals, Matthew Galeotti, the head of the Justice Department’s criminal division, told reporters during a press conference.
Investigators identified $2.9 billion in actual loss from false claims submitted to Medicare, the government health care program for seniors, and Medicaid, the federal program for low-income Americans, and were able to halt the loss of $11.7 billion.
The losses were less than a sixth of the amount authorities were able to prevent from being stolen “by getting ahead of schemes early,” said Galeotti.
In the biggest case announced last week, a Russia-based network was caught defrauding Medicare using personal data stolen from more than a million Americans.
The network submitted $10.6 billion in reimbursement claims for various medical devices in the name of those patients and without their knowledge.
A total of 19 people have been charged in the United States in the case, 12 of whom have been arrested, including four in Estonia in cooperation with Estonian authorities, officials said last week.
“We are seeing a disturbing trend of transnational criminal organizations engaging in increasingly sophisticated and complex criminal schemes that defraud the American health care system,” Galeotti said.
“As part of this takedown, we’ve identified and charged defendants operating from Russia, Eastern Europe, Pakistan and other foreign countries.”
According to Christopher Delzotto, head of the FBI’s health insurance fraud unit, of the 324 indicted individuals, 96 were licensed healthcare professionals including 25 physicians.
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© Agence France-Presse
