58 Charged in $66M Medicare Fraud, Pill Mill Operation
In a coordinated health care fraud enforcement operation, the Justice Department has announced charges against 58 individuals across all four federal districts in Texas for their alleged involvement in Medicare fraud schemes and networks of ‘pill mill’ clinics, resulting in $66 million in losses and 6.2 million pills. Of those charged, 16 were doctors or medical professionals, and 20 were charged for their role in diverting opioids.
The operation was led and coordinated by the Health Care Fraud Unit of the Criminal Division’s Fraud Section in conjunction with its Medicare Fraud Strike Force (MFSF) partners. The MFSF is a partnership among the Criminal Division, U.S. Attorney’s Offices, the FBI, Health and Human Services-Office of Inspector General (HHS-OIG), and the Drug Enforcement Administration (DEA).
The charges announced today aggressively target schemes billing Medicare, Medicaid, TRICARE, the Department of Labor-Office of Worker’s Compensation Programs, and private insurance companies for medically unnecessary prescription drugs and compounded medications that often were never even purchased and/or distributed to beneficiaries. The charges also involve individuals contributing to the opioid epidemic, with a particular focus on medical professionals allegedly involved in the unlawful distribution of opioids and other prescription narcotics, a particular focus for the Department.
According to the Centers for Disease Control, approximately 115 Americans die every day of an opioid-related overdose.
U.S. Attorney Brian A. Benczkowski said, ‘Today’s charges highlight the amazing work being done by the Department’s Medicare Fraud Strike Force and our partners in Texas. As we continue to dedicate resources to battle healthcare and opioid fraud schemes in Texas and elsewhere, we are shining an inescapable light on dirty doctors, clinic owners, pharmacists, and others who may have long believed they could perpetrate their frauds behind closed doors.’
U.S. Attorney Erin Nealy Cox of the Northern District of Texas added, ‘Healthcare should revolve around patients’ well-being – not providers’ personal interests. When medical professionals line their own pockets by submitting false insurance claims or prescribing unnecessary medications, equipment, or treatments, it not only drains taxpayer coffers – but it makes healthcare more expensive for everyone else.’
U.S. Attorney Ryan K. Patrick of the Southern District of Texas said, ‘Sadly, opioid proliferation is nothing new to Americans. What is new, is the reinforced fight being taken to dirty doctors and shady pharmacists. Texas may have four U.S. Attorneys, but we are focused on one health care mission: shutting down pills mills and rooting out corruption in health care.’
U.S. Attorney Joseph D. Brown of the Eastern District of Texas stated, ‘Every dollar stolen from Medicare through fraud comes out of the pocket of taxpayers. These are real costs that help drive up the cost of medical services for everyone. It is important that there be real consequences for those who cheat the system.’
Related Federal Cases
- Juan A. Tony Marrero, Medicare Fraud Scheme, Miami FL, 2023 · Florida
- Shannon Tecoko Mays, Conspiracy to Commit Wire Fraud, Texas, 2012 · Texas
- James Pavlounis, Social Security Administration Fraud and Tax Evasi… · Texas
- Tren de Aragua Leaders Unsealed, Terror Cartel Crimes, Texas, 2023 · New Mexico
- John Q. Smith, $50M Fraud Ring, Washington DC, 2025 · Washington
Key Facts
- State: Texas
- Category: Drug Trafficking|Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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