Federal prosecutors have recently uncovered one of the largest healthcare fraud and money laundering schemes in U.S. history, involving billions in fraudulent claims and multiple co-defendants. Hafizullah Ebady, a member of a Moscow-based criminal ring, pleaded guilty to participating in this scheme, the seventh of eight co-defendants to do so. The group's ringleader is said to be Brian Sutton, a U.S. citizen who remains at large in Russia.

The massive scam was a complex web of fraud that affected at least 50 pharmacies in the U.S. and internationally. The defendants orchestrated the scheme by acquiring pharmacies across the U.S. that already had established relationships with private health insurers. Using these pharmacies as a front, they partnered with call centers to persuade individuals to accept unnecessary medications and enlisted a network of doctors to generate fake prescriptions. The scheme produced over $1.7 billion in fraudulent prescription claims filled through the participating pharmacies.

Ebady faces a prison sentence of up to 10 years and substantial financial penalties.

Healthcare fraud is a serious federal charge with far-reaching repercussions. The Lento Law Firm's Criminal Defense Team has experienced healthcare and financial fraud defense attorneys with the skills and knowledge to develop a robust defense strategy to achieve the best possible outcome. Contact us online or at 888.535.3686 to set up a consultation.

What Is Healthcare Fraud?

Healthcare fraud is a white-collar crime in which individuals—often healthcare professionals—seek payments for unneeded or non-existent services. Such fraud is prosecuted under federal laws, including the Health Insurance Portability and Accountability Act (HIPAA), which was enacted in 1996 to address and prevent fraudulent activities. Federal statutes enable the government to bring criminal charges against individuals who attempt to deceive healthcare programs or file false claims. Healthcare fraud costs the U.S. more than $100 billion each year.

Common Types of Healthcare Fraud

Healthcare fraud often targets government programs like Medicare or Medicaid. Typical schemes include:

• Operating "pill mills" to distribute drugs illegally
• Accepting kickbacks for unwarranted referrals
• Billing for medically unnecessary tests or procedures
• Billing for services or goods that weren't provided
• Charging personal expenses to Medicaid
• Submitting multiple bills for the same service (double billing)
• Billing for a more expensive service than the patient received.

Patients can also be charged with fraud. Common fraudulent acts include:

• using another person's health insurance or allowing another person to use theirs.
• creating or using a forged prescription
• visiting multiple providers to obtain prescriptions for controlled substances
• obtaining prescriptions for controlled substances from medical offices that engage in unethical practices.

Consequences of Healthcare Fraud

Convictions for healthcare fraud carry heavy penalties. A basic offense can lead to a 10-year prison term, while severe injury cases may result in up to 20 years. If death results, a life sentence may be imposed. Fines are substantial, up to $250,000 per offense for individuals and $500,000 for organizations. Medical professional found guilty of healthcare fraud are at serious risk of losing their license to practice.

Hire Experienced Criminal Defense Lawyers

Individuals facing healthcare fraud allegations should talk to Lento Law Firm's Criminal Defense Team immediately. Our firm's skilled healthcare and financial fraud defense attorneys are standing by, ready to help you defend against the charges and reach the best possible outcome. Contact us online or at 888.535.3686 to set up a consultation.