The indictment also alleges that the conspiracy to bribe practitioners and to defraud insurers generated substantial profits for the defendants, their company, and for the co-conspirator practitioners.
"Causing the unnecessary use of opioids by current and retired US military service members shows disregard for their health and disrespect for their service to our country," said Special Agent in Charge Craig Rupert of the Defense Criminal Investigative Service (DCIS), Northeast Field Office. "DCIS will continue to partner with the DOJ and our fellow law enforcement agencies to address conduct such as this and protect America's Warfighters."
"EBSA is very pleased to had the opportunity work collaboratively with our law enforcement partners in this important investigation," said Susan A. Hensley, Regional Director of the US Department of Labor, Employee Benefits Security Administration, Boston Regional Office.
"I commend the exceptional work performed by our criminal investigators and their law enforcement partners," said Scott Rezendes, Special Agent in Charge of the US Office of Personnel Management, Office of Inspector General, Office of Investigations. “It is utterly unacceptable to risk the safety and well-being of patients in order to increase profits. This office will continue to vigorously pursue any and all cases that may jeopardize the health of Federal employees, annuitants, and their families."
"US Postal Inspection Service is committed to protecting the nation’s mail system from criminal misuse," said Shelly Binkowski, Inspector in Charge of the US Postal Inspection Service. "This investigation is an excellent example of a partnership between government agencies working together to dismantle prescription drug practices that directly contribute to the ongoing opioid abuse epidemic."
"The United States Postal Service, Office of Inspector General will continue to vigorously investigate companies that engage in improper relationships with medical providers for the purpose of increasing market share as alleged in this case," said Eileen Neff, Special Agent in Charge of the US Postal Service Office of Inspector General. "We thank our law enforcement partners for their help in preventing this type of fraud against the healthcare programs of the American public and the Postal Service."
"Misrepresenting a patient's diagnoses and using kickbacks to prescribing doctors to inflate drug sales is fraudulent activity," said Donna L. Neves, Special Agent in Charge of the US Department of Veterans Affairs, Office of Inspector General, Northeast Field Office. "Targeting veterans’ dependents using CHAMPVA with these type techniques is unacceptable. We are pleased to have contributed to this outstanding multi-agency criminal investigation and will continue to pursue allegations of health care fraud that put our veterans and their families at risk."
On the charges of conspiracy to commit RICO and conspiracy to commit mail and wire fraud, the charging statute provides a sentence of no greater than 20 years in prison, three years of supervised release and a fine of $250,000, or twice the amount of pecuniary gain or loss. On the counts of conspiracy to violate the Anti-Kickback Law, the charging statute provides a sentence of up to five years in prison, three years of supervised release and a $25,000 fine. Actual sentences for federal crimes are typically less than the maximum penalties. Sentences are imposed by a federal district court judge based upon the U.S. Sentencing Guidelines and other statutory factors.
The investigation was conducted by a team that included the FBI; HHS-OIG; FDA Office of Criminal Investigations; the Defense Criminal Investigative Service; the Drug Enforcement Administration; the Department of Labor, Employee Benefits Security Administration; the Office of Personnel Management; the U.S. Postal Inspection Service; the U.S. Postal Service Office of Inspector General; and the Department of Veterans Affairs. The U.S. Attorney would like to acknowledge the outstanding cooperation and assistance of the U.S. Attorney’s Offices around the country engaged in parallel investigations, including the District of Connecticut; the Eastern District of Michigan; the Southern District of New York; and the Southern District of Alabama. The efforts of the Central District of California and the Civil Fraud Section of the Department of Justice are also greatly appreciated.
Assistant U.S. Attorneys K. Nathaniel Yeager, Chief of Ortiz’s Health Care Fraud Unit, and Susan M. Poswistilo, of Ortiz' Civil Division, are prosecuting the case.
The details contained in the indictment are allegations. The defendants are presumed innocent unless and until proven guilty beyond a reasonable doubt.
*Controlled substance: High risk for addiction and dependence. Can cause respiratory distress and death when taken in high doses or when combined with other substances, especially alcohol.
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