The Most Expensive Medicare Fraud Cases in U.S. History
Medicare fraud has been a persistent issue in the United States, with numerous cases resulting in significant financial losses for taxpayers. Here are some of the most expensive Medicare fraud cases in U.S. history:
### Recent Case: Alexandra Gehrke and Jeffrey King
One of the largest healthcare fraud cases in U.S. history involves Alexandra Gehrke and Jeffrey King, an Arizona couple. They pleaded guilty to submitting $1.2 billion in fraudulent claims to Medicare, Medicaid, and other insurers. The scheme involved billing for unnecessary wound care procedures and receiving kickbacks from wound graft companies. Each defendant agreed to pay over $600 million in restitution and faces more than 20 years in prison[1].
### Texas Pharmacist Dehshid Nourian
In another significant case, Texas pharmacist Dehshid Nourian was sentenced to over 17 years in prison for defrauding the Department of Labor through the submission of fraudulent claims for prescription compound creams. The scheme involved paying doctors to prescribe unnecessary medications, resulting in over $145 million in fraudulent billing. Nourian was ordered to pay over $115 million in restitution and forfeit $405 million in assets[3].
### Whistleblower Cases
Whistleblowers have played a crucial role in uncovering Medicare fraud. For example, a whistleblower lawsuit against Humana resulted in a settlement of $90 million. The lawsuit alleged that Humana submitted fraudulent bids for Medicare Part D contracts, significantly overcharging the government[5]. Another notable case involved Modernizing Medicine, an electronic health-records company, which paid $45.6 million to settle allegations of kickback schemes with medical labs[5].
These cases highlight the ongoing battle against Medicare fraud and the importance of vigilance and whistleblower efforts in protecting taxpayer dollars.
