On June 28, 2018, federal authorities in Los Angeles, California announced criminal cases naming a total of 33 defendants charged with a variety of schemes to defraud public and private insurance programs out of more than $660 million.  As part of a nationwide effort to target healthcare fraud, prosecutors charged numerous defendants, including doctors, pharmacists, marketers, and an attorney.  First, nine defendants were charged in Operation “Spinal Cap,” which targeted a healthcare fraud scheme involving spinal surgeries that resulted in nearly $1 billion fraudulent claims to the federal government, California state, and private insurers.  Second, an unsealed indictment described a wide-ranging conspiracy involving kickbacks that resulted in more than $250 million in fraudulent claims for prescriptions that were filled in pharmacies in Nevada and Southern California.  Third, an individual was arrested for allegedly serving as leader of a narcotics trafficking ring that sold illegal prescriptions for cash and sold opioids and other drugs to the black market.  Fourth, an unsealed indictment charged a group of pharmacists, doctors, and marketers, with a scheme to defraud the federal TRICARE program by submitting more than $40 million in claims for medically unnecessary prescriptions.  Finally, prosecutors working under the Medicare Fraud Strike Force unsealed seven criminal cases that involved pharmacy owners’ submission of fraudulent claims to Medicare and Medi-Cal for prescription drugs.

DOJ Press Release