BREAKING NEWS: Opioid Crisis is Center of $1.3 Billion Health Care Fraud Scheme – and U.S. is Cracking Down!

BREAKING NEWS: Opioid Crisis is Center of $1.3 Billion Health Care Fraud Scheme – and U.S. is Cracking Down!


U.S. Government Cracks Down

Last week U.S. prosecutors charged more than 400 people across the country with taking part in health care fraud, and the opioid crisis is front and center of this operation. Attorney General Jeff Sessions announced these charges on July 13th, 2017 and is calling this “the largest opioid related fraud take-down in American history”. The charges range from doctors accused of partaking in a scheme to prescribe unnecessary opioids for personal profit, to rehab facilities allegedly recruiting addicts with the promise of gift cards, visits to local strip clubs and even drugs! U.S. officials state the alleged fraud includes doctors billing Medicare for 164 million dollars in false and fraudulent claims and a false rehab in Florida billing over 58 million dollars in false treatments and drug tests. One Houston doctor is accused of writing prescriptions for opioids in exchange for cash, allegedly resulting in $12,000 opioid prescriptions written for over two million opioid doses—many of which end up on the street for illegal sale. As a result of this take-down 205 health care providers have been suspended or banned from participating in federal health care programs, and the investigation is ongoing.

Opioid Crisis Hit Fever Pitch

opioid crisis
The opioid crisis in our country is being called the deadliest drug crisis in our nation’s history, with one American dying every 11 minutes from a drug overdose. Fraudulent health care billings such as the ones highlighted in this crackdown take advantage of addicts in need of real help and put in jeopardy the opportunity for real treatment centers to work with federal health care programs to get addicts the treatment they desperately need. In addition to cracking down on fraudulent billing and over prescribing, there are active legislative efforts occurring across the country as a further effort to combat the opioid crisis. Many states such as: New Jersey, Arizona, Connecticut, Delaware, Maine, Massachusetts, New York, Pennsylvania, Rhode Island, Vermont and Ohio have already passed laws limiting the length of time an initial opiate prescription can be written for. Now, modeled after the laws in many of these states, there is federal legislation making its way through the process of passing a bill into law that is seeking to limit initial opiate prescriptions for acute pain to no more than seven days.

New Legislation

jeff sessions opioidsThis bill is called the Opioid Addiction Prevention Act of 2017, and if passed it would greatly cut down on the amount of opiate pills doctors are able to prescribe for acute injuries and illnesses as well as require them to provide more proof of necessity to prescribe opioid prescriptions for longer periods of times or those which allow for refills. The Center for Disease Control and Prevention has developed the CDC Guideline for Prescribing Opioids for Chronic Pain which not only includes recommendations on limiting opiate prescriptions to no more than is needed to treat acute pain, but also goes as far as encouraging doctors to check Prescription Drug Monitoring Programs for prescriptions from other doctors prior to prescribing opiates, suggests using urine drug testing on their patients to check for undisclosed prescription use, and asks them to help arrange treatment for any of their patients who are in need of opioid use disorder treatment.

over prescribing opiates Now What?

So what does this mean for the treatment industry and the opioid crisis? Here at Elevate we are pleased to see that the over prescribing of medications and fraudulent treatment billing is being taken so seriously. Following the press conference regarding this issue and the new federal legislation in the works one thing is abundantly clear – dealing with the opioid crisis in our country has never been more dire; we are happy to be a part of the solution to this devastating problem and are hopeful that as the treatment industry and medical industry as whole moves further away from over prescribing unnecessary medications, more treatment centers and doctors across the country can find success with holistic treatment the same way we have.