Photo: Toby Talbot (AP)

Federal prosecutors have charged hundreds of people with allegedly defrauding the US government’s health care system out of a combined $2 billion. And many of the charged are doctors who are also being accused of aiding the opioid crisis by illegally prescribing more than 13 million doses of powerful, addictive painkillers to vulnerable patients.

The US Department of Justice announced the charges on Thursday, declaring it to be the single largest health care fraud enforcement action ever taken. More than 600 people across 58 federal districts are charged with participating in schemes that amounted to more than $2 billion in fraudulent billings made to private and public insurance providers, such as Medicare and Medicaid. Of those, more than 150 defendants—of which 76 are doctors—are also charged with illegally prescribing and distributing opioids and other mind-altering narcotics, such as sleeping pills.

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“This is the most fraud, the most defendants, and the most doctors ever charged in a single operation—and we have evidence that our ongoing work has stopped or prevented billions of dollars’ worth of fraud,” said Attorney General Jeff Sessions in a statement.

The defendants, which also include patient recruiters, pharmacy owners, and patients themselves, are said to have provided doctors access to patient information in exchange for cash kickbacks. These doctors are then alleged to have submitted claims to insurance providers for unneeded treatments and services that often never ended up in the patient’s hands. Instead, as allegedly seen in a scheme in southern Texas that involved 48 co-conspirators, pharmacies would use these fraudulent prescriptions to amass a bulk supply of opioids that were then sold to drug couriers for millions of dollars.

Other types of alleged schemes highlighted by the DOJ on Thursday included a $7 million conspiracy in Brooklyn, NY that had patients referred to an ambulette company in exchange for kickbacks. In Tennessee, five defendants were charged with aiding a more than $2.5 million conspiracy that involved fraudulently billed medical equipment. And in Illinois, 21 individuals were charged with defrauding insurers via fake home health and dental services.

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The department of Health and Human Services announced its own similar crackdown. Since July 2017, the agency reported Thursday, it has barred 2,700 people from being able to participate in all federal health programs. The tally includes 587 health care providers who have been reprimanded for “conduct related to opioid diversion and abuse.”’

The federal crackdown is unrelated to recent lawsuits, brought by state attorneys, that accuse opioid drug companies of marketing opioids as being less addictive than they actually are.