Fortune | FORTUNE 07月01日 04:55
Inside Operation Gold Rush: How a transnational criminal network exploited the U.S. health care system out of $14.6 billion
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美国司法部宣布,超过320人因涉嫌医疗欺诈被起诉,涉案金额高达150亿美元,这是司法部历史上最大规模的医疗欺诈案件。该欺诈行为涉及虚假索赔,导致29亿美元的实际损失。调查揭示了跨国犯罪网络利用美国医疗保健系统的行为,其中包括俄罗斯、东欧和巴基斯坦等地的犯罪分子。当局查获了超过2.45亿美元的现金、豪华车辆、加密货币和其他资产。案件包括一个涉及100亿美元的尿导管计划,突显了跨国犯罪组织使用的复杂手段。

💰 司法部发起了大规模打击行动,起诉了320多人,发现了近150亿美元的虚假索赔,涉及近190起联邦案件和90多起州案件,这是司法部历史上最大规模的医疗欺诈案件。

🌍 调查显示,跨国犯罪网络参与其中,犯罪分子来自俄罗斯、东欧、巴基斯坦等多个国家,他们利用美国医疗保健系统进行欺诈,并盗取美国纳税人的资金。

🚨 案件涉及多种欺诈手段,包括一个价值100亿美元的尿导管计划,该计划利用外国代理人秘密收购医疗用品公司,并使用被盗身份和健康数据提交虚假医疗保险索赔。

👨‍⚕️ 近100名持牌医疗专业人员被起诉,其中包括25名医生。政府报告称实际损失达到29亿美元,执法部门查获了超过2.45亿美元的现金、豪华车辆、加密货币和其他资产。

State and federal prosecutors have charged more than 320 people and uncovered nearly $15 billion in false claims in what they described Monday as the largest coordinated takedown of health care fraud schemes in Justice Department history.

Law enforcement seized more than $245 million in cash, luxury vehicles, cryptocurrency, and other assets as prosecutors warned of a growing push by transnational criminal networks to exploit the U.S. health care system. As part of the sweeping crackdown, officials identified perpetrators based in Russia, Eastern Europe, Pakistan, and other countries.

“These criminals didn’t just steal someone else’s money. They stole from you,” Matthew Galeotti, who leads the Justice Department’s criminal division, told reporters Monday. “Every fraudulent claim, every fake billing, every kickback scheme represents money taken directly from the pockets of American taxpayers who fund these essential programs through their hard work and sacrifice.”

The alleged $14.6 billion in fraud is more than twice the previous record in the Justice Department’s annual health care fraud crackdown. It includes nearly 190 federal cases and more than 90 state cases that have been charged or unsealed since June 9. Nearly 100 licensed medical professionals were charged, including 25 doctors, and the government reported $2.9 billion in actual losses.

Among the cases is a $10 billion urinary catheter scheme that authorities say highlights the increasingly sophisticated methods used by transnational criminal organizations. Authorities say the group behind the scheme used foreign straw owners to secretly buy up dozens of medical supply companies and then used stolen identities and confidential health data to file fake Medicare claims.

Nineteen defendants have been charged as part of that investigation — which authorities dubbed Operation Gold Rush — including four people arrested in Estonia and seven people arrested at U.S. airports and at the border with Mexico, prosecutors said. The scheme involved the stolen identities and personal information of more one million Americans, according to the Justice Department.

“It’s not done by small time operators,” said Dr. Mehmet Oz, who leads the Centers for Medicare and Medicaid Services. “These are organized syndicates who are designing to hurt America.”

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医疗欺诈 司法部 欺诈案 跨国犯罪
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