Federal officials charged 13 North Texas defendants in healthcare fraud cases as part of an annual, national effort.<\/p>\n
The U.S. Attorney for the Northern District of Texas, Ryan Raybould, announced the results of the office\u2019s participation in the \u201c2026 National Healthcare Fraud Takedown\u201d during a press conference Tuesday. The seven cases across the district represent more than $365 million in alleged fraudulent billing.<\/p>\n
Raybould said fraud has never been \u201cmore rampant,\u201d and the need for enforcement has never been greater.<\/p>\n
\u201cA lot of this is a focus thing, where we are seeing more and more fraud the more that we dig,\u201d he said. \u201cI don\u2019t have the data at my fingertips now, but I can tell you, we\u2019ve charged $360 million in a healthcare fraud takedown with the same agents that we work with day-in and day-out.\u201d<\/p>\n
The cases include one involving the owner and CEO of a hospice provider in Garland who allegedly “recruited patients who were ineligible for hospice care and billed Medicare for services that were never provided.” Other cases include allegations of illegal kickbacks, bribes and other fraudulent practices. <\/p>\n
The Northern District of Texas worked with the Federal Bureau of Investigation, as well as the offices of inspector general for other federal agencies \u2013 including the U.S Department of Health and Human Services, U.S. Department of Veteran Affairs and the U.S. Department of Defense, also referred to as the U.S. Department of War.<\/p>\n
Joseph Rothrock, the special agent in charge of the FBI\u2019s Dallas field office, said the agency\u2019s involvement resulted in indictments for 10 of the 13 defendants with \u201cties to North Texas\u201d for healthcare fraud charges.<\/p>\n
\u201cTo effectively reduce fraud against the government, collaboration is key,\u201d Rothrock said. \u201cTogether, we are making an impact by identifying and investigating individuals responsible for these schemes that would defraud our government-sponsored health care programs.\u201d<\/p>\n
The cases also involve fraud against private insurers, but mainly focus on fraud committed against public programs, like Medicaid, Medicare or Tricare \u2013 the healthcare program that provides coverage to military service members.<\/p>\n
Chad Gosch, special agent in charge of the defense department\u2019s Defense Criminal Investigative Service, said losses because of fraud can erode the resources intended for vulnerable populations.<\/p>\n
\u201cThe overwhelming majority of healthcare providers who support our service members and their families do so honorably,\u201d he said. \u201cToday’s takedown shines a bright light on fraudulent schemes that have targeted Tricare for years. These are not victimless crimes. They threaten medical readiness. They undermine the trust in our military healthcare system, and they divert funds intended for legitimate care.\u201d<\/p>\n
The Northern District of Texas was one of more than 35 districts that participated in the national anti-fraud initiative.<\/p>\n
The effort resulted in more than 450 defendants charged in connection with more than $6.5 billion in alleged fraud, according to a statement from the U.S. Department of Justice<\/a>. The agency said 90 \u201cdoctors and other licensed medical professionals\u201d across the country were charged.<\/p>\n \u201cToday\u2019s Takedown represents a new era in federal, state, and international cooperation to combat health care fraud: cases in 56 federal districts and 45 U.S. states and territories, with 50 state Medicaid Fraud Control Units participating, the most in Department history,\u201d the department said in a statement.<\/p>\n The statement also said the Centers for Medicare and Medicaid Services suspended more than 1,000 providers and revoked billing privileges for more than 1,400 providers nationwide.<\/p>\n Raybould said North Texas has participated before, including last year when it pursued four cases. He said this year was not only bigger but required more collaboration between agencies.<\/p>\n \u201cThe partnerships are deeper,\u201d he said. \u201cWe\u2019ve always been good partners, but they\u2019re even better.\u201d<\/p>\n The Northern District covers more than 100 counties in Texas. A majority of the cases included in the 2026 effort are in the Dallas division. Raybould said at least one case is in the Fort Worth division, which he said moves very quickly on these types of cases.<\/p>\n However, Raybould said he and other officials hope to bring these types of cases outside of Dallas and Fort Worth.<\/p>\n \u201cHistorically, for whatever reason, we haven\u2019t brought a lot of healthcare fraud cases in West Texas, which I think is something I\u2019d like to change,\u201d he said. \u201cWe have to trust juries across 100 counties, not just in Dallas, to hear and see these cases, as well as the judges.\u201d<\/p>\n In addition to federal officials, Texas officials are focused on potential fraud in the state\u2019s Medicaid program \u2013 despite acknowledging the state has one of the lowest Medicaid fraud rates in the country<\/a>.<\/p>\n Raybould said the increase in attention has affected where he directs resources. While he said his office has done well in addressing the issue in the past, Raybould said there\u2019s room to improve.<\/p>\n \u201cWe are putting more and more attention and more resources into our fraud efforts,\u201d he said.<\/p>\n Abigail Ruhman is KERA\u2019s health reporter. Got a tip? Email Abigail at\u00a0aruhman@kera.org<\/a>.<\/p>\n