US: 193 Now Charged Over $2.75 Billion in Fraudulent Health Care Claims

Published: 03 July 2024

health-insurance-medical-careThe four accused are part of a larger case involving 193 defendants who allegedly schemed to defraud the U.S. healthcare system of $2.75 billion. (Photo: Mohamed Hassan, PxHere, License)

By Henry Pope

The U.S. charged four people in connection with an alleged scheme, which now involves 193 defendants, to defraud federal health care programs of more than US$2.75 billion through the submission of fake opioid prescriptions.

The 193 defendants each conspired to procure unnecessary opioid prescriptions on behalf of an online telehealth company, so that the prescriptions could be filed for reimbursement through Medicare and Medicaid, America’s largest health insurance programs.

In doing so, they knowingly made fraudulent orders to pharmacists and obstructed pharmacy efforts to exercise their corresponding responsibility, said Matthew Yelovich, Deputy Chief of the Criminal Division of the U.S. Attorney’s Office for the Northern District of California.

The charges are part of a two-week nationwide law enforcement action that has tracked more than $2.75 billion in purported reimbursement submissions to be paid for by U.S. taxpayers.

“The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets,” prosecutors said. So far, authorities have retrieved roughly $231 million in cash, luxury vehicles, gold, and other assets linked to the alleged scheme.

Riley Levy, 30, of Arizona, was charged with conspiracy to distribute controlled substances as part of the $2.75 billion scheme. As alleged in the indictment, he did this by conspiring to distribute Adderall and other stimulants “that were not for a legitimate medical purpose,” prosecutors said.

Christopher Lucchese, 58, of Texas, received the same charges. But as a medical doctor, he allegedly played a role in issuing the opioid prescriptions which were never intended for legitimate medical purposes.

Yelovich denounced the conspirators’ alleged actions, commenting that making controlled substances available to persons without a legitimate medical purpose is akin to drug dealing.

Yina Cruz, 37, of New Jersey, allegedly used her position as a nurse to aid others file false prescriptions, including opioids to Medicare and Medicaid beneficiaries., prosecutors said.

The fourth defendant, Katrina Pratcher, 70, of California, also a nurse practitioner, was charged similarly to Cruz.

“It does not matter if you are a trafficker in a drug cartel or a corporate executive or medical professional employed by a health care company, if you profit from the unlawful distribution of controlled substances, you will be held accountable,” said Attorney General Merrick B. Garland. “The Justice Department will bring to justice criminals who defraud Americans, steal from taxpayer-funded programs, and put people in danger for the sake of profits.”