10 Charged in $1 Billion Medical Insurance Fraud

2020-06-29

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Ten people have been indicted in a complex scheme to allegedly defraud private insurance companies of more than $1 billion for medical testing.

The Justice Department unsealed the indictments Monday in Jacksonville, Florida. Eight of the defendants are from Florida. The others are from Atlanta and Chicago

The charges include conspiracy to commit health care fraud and money laundering.

"The FBI views health care fraud as a severe crime problem that impacts every American," said Special Agent Rachel Rojas. "Fraud and abuse take critical resources out of our health care system and contribute to the rising cost of health care for everyone."

According to the indictment, the 10 suspects owned management companies that would take over small rural hospitals.

They allegedly carried out expensive medical tests at private laboratories, but billed insurance companies at a higher rate as if the tests were done at the hospitals. The indictment says many of those tests were unnecessary.

"Schemes that exploit rural hospitals are particularly egregious as they can undermine access to care in underserved communities," said an inspector general in the Office of Personnel Management.

Three of the suspects were arraigned Monday. Their pleas of guilt or innocence were not announced. The seven remaining defendants will appear before a judge later this week.