Iranian Regime Using Water as a Weapon and APT 33

Posted on July 2, 2018July 2, 2018 by Denise Simon

The Iranian people have been protesting against the regime for quite some time and in some cases it has turned deadly, where military forces are firing on the protestors. What are the protests about? Their economy. Remember when the Obama White House gave Iran billions that apparently we owed from back debts and the regime was to use the money to infuse growth in the economy? Yeah, not so much. In fact the starving and unemployed citizens of Iran are demanding the regime get out of Syria and pay attention at home.

Yet, water availability in Iran has been at a crisis point for a few years and getting worse.

Dozens of riot police on motorcycles faced off against farmers in the same town, Varzaneh, another video showed. Smoke swirled around the protesters and the person filming said tear gas was being fired. A second person reported clashes. Police in the city of Isfahan were not immediately available to comment.

“What’s called drought is more often the mismanagement of water,” said a journalist in Varzaneh, who asked not to be identified because of the sensitivity of the subject.

“And this lack of water has disrupted people’s income.”

Farmers accuse local politicians of allowing water to be diverted from their areas in return for bribes.

While the nationwide protests in December and January stemmed from anger over high prices and alleged corruption, in rural areas, lack of access to water was also a major cause, analysts say.

At least 25 people were killed and, according to one parliamentarian, up to 3,700 people were arrested, the biggest challenge yet for the government of president Hassan Rouhani, who was reelected last year. More here from Reuters.

Meanwhile, in Paris there are several Americans attending the annual National Council of Resistance of Iran (NCRI) – an umbrella bloc of opposition groups in exile that seek an end to Shi’ite Muslim clerical rule in Iran. There apparently was a bomb plot on Monday that was foiled, where an Iranian diplomat was arrested along with several others.

Since President Trump formally exited the JCPOA, the nuclear deal, Iran has some nefarious activities again in play and that includes hacking beyond punishing the Iranian citizens and bomb plots.

Since the 2009 Green Revolution in Iran, the Iranian Revolutionary Guard Corps has taken to hacking including by proxy.

The emergence of the Iranian Cyber Army (ICA) as an extension of the IRGC was an initial attempt by the Islamic Republic at conducting internationally focused operations. These operations were a departure from Gerdab’s focus on maintaining domestic moral values and defending government rhetoric. In 2011, the IRGC’s ICA formed the foundation of the Khaybar Center for Information Technology. According to a former IRGC cyber commander, the Khaybar Center was established in 2011 and has been linked to a number of attacks against the United States, Saudi Arabia, and Turkey.

Even today, the balance between ideology and cyber skills remains problematic. One example of the conflict between ideology and skill was Mohammad Hussein Tajik, a former cyber commander within the IRGC. According to Insikt Group’s source, Tajik’s father maintained a strong religious background and was a veteran of Iran’s ministry of intelligence. Yet Tajik was arrested and killed because the Iranian government feared that Tajik was not ideologically aligned and posed a betrayal and flight risk.

Today, based on ongoing contact between Insikt Group’s source and Iranian hackers, it is estimated that there are over 50 organizations vying for government-sponsored offensive cyber projects. Only the best teams succeed, are paid, and remain in business. The government does its best to compartmentalize — one job might be creating a remote code exploit (RCE) for a popular software application, while another job might be using the RCE and establishing persistent unauthorized access. Two different contractors (or more) are typically required to complete the government-defined objective.

Public knowledge has also established that Iranian academic institutions play a contractor-like role. Specific examples include Shahid Beheshti University (SBU) and the Imam Hossein University (IHU), which have comprehensive science and technology departments attracting some of the best academic talent in Iran. In fact, the SBU has a specific cyberspace research institute dedicated to such matters, and the IHU was founded by the IRGC.

For a full read on the report due to an interview with a previous Iranian hacker and significant research on state sponsored campaigns, go here.

Cyber security professionals in the United States have detected Iranian hackers breaking into defense contractors, aviation systems, energy companies, telecom operations and other tech companies in the United States. Iran is listed at APT 33, Advanced Persistent Threat and Saudi Arabia is just as vulnerable as the United States. In 2016, the Department of Justice indicted 7 Iranians on cyber attacks on dozens of U.S. banks, attempting to shut down the Bowman Avenue dam operation in New York and to disrupt other critical U.S. infrastructure sites. 45 major financial institutions were targeted including JP Morgan, Well Fargo and American Express. Read more detail here.

Ridiculous Deductibles Broke the Healthcare System

Posted on July 1, 2018July 1, 2018 by Denise Simon

Hello democrats….what again did Obamacare solve?

Sky-High Deductibles Broke the U.S. Health Insurance System

Employers are questioning a system they say costs patients too much.

Bloomberg: When Carla Jordan and her husband were hit with a cascade of serious medical issues, she knew that at least her family had health insurance through her job. What she didn’t realize was that even with that coverage, a constant stream of medical bills would soon push the family to the edge of financial collapse.

The Jordans, both 40, were once solidly in the middle class, but ever since the 2008 financial crisis, money has been tight at best. Then calamity hit. In 2016, Carla needed a gallbladder operation. Her husband John suffered a seizure the same year, followed by an unrelated infection that sent him to the emergency room. Toward the end of the year, Carla was diagnosed with diabetes. Even after paying $501 a month for medical insurance, they ended the year owing $8,000 to 18 different providers, with creditors threatening to garnish John’s wages.

Health plans similar to the Jordans’ that put patients on the hook for many thousands of dollars are widespread and growing, but some employers are beginning to have second thoughts. “Why did we design a health plan that has the ability to deliver a $1,000 surprise to employees?” Shawn Leavitt, a senior human resources executive at Comcast Corp., said at a conference in May. “That’s kind of stupid.” A handful of companies, including JPMorgan Chase & Co. and CVS Health Corp., have recently announced plans to reduce deductibles or cover more care before workers are exposed to the cost.

Yet it’s still the reality for a growing share of Americans. Today, 39 percent of large employers offer only high-deductible plans, up from 7 percent in 2009, according to a survey by the National Business Group on Health. Half of all workers now have health insurance with a deductible of at least $1,000 for an individual, up from 22 percent in 2009, according to data from the Kaiser Family Foundation. About 41 percent say they can’t pay a $400 emergency expense without borrowing or selling something, according to the Federal Reserve. The bottom line: People like the Jordans simply can’t afford to get sick.

Deductibles Keep Rising

About 40 percent of Americans can’t afford an unexpected $400 expense, according to the Federal Reserve.

***

The family had an Anthem Inc. insurance policy through Carla’s job as a public school teacher in Stafford County, Virginia. But the monthly premium barely covered any of their bills before paying a $2,000 deductible. And by the end of 2016, the Jordans were deep in the hole to doctors, hospitals, an anesthesiologist, urgent care, and various labs and testing centers. Their doctors sent collections notices. Some dropped them as patients until they paid up.

“I actually dreaded going to the mailbox,” Carla recalled. “I feel like I’ve done everything I’m supposed to do.” And yet, she said, sickness pushed the family “right over the brink.”

Since the early 2000s, employers have mostly embraced high-deductible health plans. The thinking has been that requiring workers to shoulder more of the cost of care will also encourage them to cut back on unnecessary spending. But it didn’t work out that way. In the wake of the 2008 financial crisis, many families were hard-pressed to meet their soaring health-insurance deductibles. At the same time, studies show that many put off routine care or skipped medication to save money. That can mean illnesses that might have been caught early can go undiagnosed, becoming potentially life-threatening and enormously costly for the medical system.

Patients Exposed

The share of Americans under 65 enrolled in high deductible plans is rising

The family had an Anthem Inc. insurance policy through Carla’s job as a public school teacher in Stafford County, Virginia. But the monthly premium barely covered any of their bills before paying a $2,000 deductible. And by the end of 2016, the Jordans were deep in the hole to doctors, hospitals, an anesthesiologist, urgent care, and various labs and testing centers. Their doctors sent collections notices. Some dropped them as patients until they paid up.

“I actually dreaded going to the mailbox,” Carla recalled. “I feel like I’ve done everything I’m supposed to do.” And yet, she said, sickness pushed the family “right over the brink.”

Since the early 2000s, employers have mostly embraced high-deductible health plans. The thinking has been that requiring workers to shoulder more of the cost of care will also encourage them to cut back on unnecessary spending. But it didn’t work out that way. In the wake of the 2008 financial crisis, many families were hard-pressed to meet their soaring health-insurance deductibles. At the same time, studies show that many put off routine care or skipped medication to save money. That can mean illnesses that might have been caught early can go undiagnosed, becoming potentially life-threatening and enormously costly for the medical system.

Patients Exposed

The share of Americans under 65 enrolled in high deductible plans is rising.

***

How the U.S. insurance system came to stick its customers with increasingly onerous medical bills is a 15-year-long story of miscalculations and missed opportunities. It started in 2003 when President George W. Bush and congressional Republicans passed a change to the tax code that encouraged employers to experiment with high-deductible plans, which ask patients to pay out of pocket for care — sometimes thousands of dollars — before insurance coverage kicks in. The trend got a push when the financial crisis hit: As the economy stalled and employers shed nearly 9 million jobs over three years, companies desperate to slash costs turned to high-deductible plans to save money. The next wave came with the arrival of Obamacare in 2010. Millions who were previously uninsured could now get coverage, but many of them took on deductibles of $1,000 or higher.

The Jordan family never expected to become a casualty of the trend. Little more than a decade ago, they were making more than $100,000 a year. John Jordan had a carpentry business that did well during the housing boom. Carla’s job teaching computer science classes at a local high school gave them steady income and health benefits. When their children, now teenagers, were first born, she recalls paying $500 for her maternity stays in the hospital.

“That was the biggest bill we ever got,” she said.

Since then, Carla’s salary has barely increased and John’s business never recovered after the crash. With student loans, car notes and a house worth less than their mortgage, the Jordans filed for bankruptcy in 2013, allowing them to discharge some debts. But their income never fully bounced back.

They were ill-prepared to deal with sharply escalating health-care bills: Carla’s gallstone, her diabetes diagnoses, John’s seizures, followed by a serious campylobacter infection. The family couldn’t afford the $1,000 it would cost for Carla’s six-week diabetes class. Instead, she got a 40-minute crash course. They shelled out $125 for five pills to treat John’s infection. Still, the bills were piling up. Early in 2017, Carla took a day off from work to go through the stacks of paper, calling each office to negotiate. Few were willing to help.

“It did not really matter to them,” she said. “It was just, ‘When can you pay and how much can you pay?’”

By last year, the couple was making about $79,000, before taxes. They have no savings for retirement or for their children to go to college. “We both live paycheck-to-paycheck,” Carla said. They pay about $35 a month for medications for John’s blood pressure and acid reflux. Carla takes inexpensive metformin—just $3 a month—for diabetes, and doesn’t yet need insulin.

But her diabetes test strips and lancets cost $120 for a three-month supply. To stretch them as long as she can, she checks her blood sugar only when she feels dizzy or nauseous, rather than the standard three times a day. When she had the flu this past winter, she put off going to the doctor until her fever hit 105.

The Jordans’ response to spiraling family medical costs is repeated in families across the country, studies suggest. When one large employer switched all its employees to high-deductible plans, medical spending dropped by 12 percent to 14 percent, according to an analysis by economists at University of California, Berkeley and Harvard. But the workers weren’t learning to shop more effectively for health care. They simply reduced the amount of medical care they used, including preventative care. In high-deductible plans, women are more likely to delay follow-up tests after mammograms, including imaging, biopsies and early-stage diagnoses that could detect tumors when they’re easiest to treat, according to research in the Journal of Clinical Oncology.

“High-deductible plans do reduce health-care costs, but they don’t seem to be doing it in smart ways,” said Neeraj Sood, director of research at the Leonard D. Schaeffer Center for Health Policy and Economics at the University of Southern California.

Some big companies are sitting up and taking notice. “We all thought high deductibles are going to drive people to get involved—‘skin in the game,’” Jamie Dimon, the chief executive officer of JPMorgan, said in early June. Instead, “they didn’t get the surgery they needed, when they needed it, because they can’t afford the high deductible in one shot.” JPMorgan is effectively eliminating deductibles for workers making less than $60,000 a year.

Dimon has teamed up with the top executives of Amazon.com Inc. and Berkshire Hathaway Inc. to improve the health care they provide for their workers. The incoming CEO of that venture, surgeon and journalist Atul Gawande, has also noticed the plight of such families as the Jordans. “I had one friend who was bankrupted with a health plan,” Gawande said at the Spotlight Health event in Aspen, Colorado, on Saturday. “He had a $3,000 deductible and couldn’t meet it.”

About five years ago, CVS switched all of its 200,000 employees and their families to health-insurance plans with high deductibles. As the company pushed more costs onto employees, some stopped taking their medications.

“Nobody in their right mind would think that it’s a smart thing to basically be keeping people away from taking their medications,” said Troy Brennan, the chief medical officer at CVS. The company had initially offered a limited selection of generic drugs for free to its workers. But evidence that people were skipping medications prompted CVS to broaden the list, including some brand-name treatments and insulins on the free-drug list, an approach it now recommends to its corporate customers.

The company is also studying a plan to allow employers to offer free, branded drugs to workers in cases where CVS has already negotiated deep discounts. The plan could be in place as soon as 2019.

For the Jordans, such changes are late in coming. On New Year’s Day, 2017, Carla Jordan sat down with her laptop at her kitchen table to write a 20-page letter railing against insurance companies and high medical costs, replete with tables showing their expenses and eight pages of references. She pointed out that health insurance companies’ stock prices, not to mention industry executive salaries, were both soaring, while the thousands of dollars in premiums she paid protected neither her family’s health nor its finances.

“This is an urgent situation, with dire consequences,” she wrote. “Please take action immediately.” She sent the letter to then-President Barack Obama, President-Elect Donald Trump and 220 members of Congress. Only four responded. Seven months later—and for the second time in four years—the couple filed for bankruptcy.

Question China and They Were Uninvited to RIMPAC

Posted on July 1, 2018July 2, 2018 by Denise Simon

The U.S. Navy and allies are drilling in the Pacific Ocean as part of the massive Rim of the Pacific naval exercise. After years continuing to sail alongside China in RIMPAC, even as the peer competitor militarized man-made islands in the South China Sea, the U.S. decided enough is enough and rescinded the invitation. (Andrew Jarocki/Staff)

Twenty-six nations, 47 surface ships, five submarines, 18 national land forces, and more than 200 aircraft and 25,000 personnel will participate in the biennial Rim of the Pacific (RIMPAC) exercise scheduled June 27 to Aug. 2, in and around the Hawaiian Islands and Southern California. As the world’s largest international maritime exercise, RIMPAC provides a unique training opportunity designed to foster and sustain cooperative relationships that are critical to ensuring the safety of sea lanes and security on the world’s interconnected oceans. RIMPAC 2018 is the 26th exercise in the series that began in 1971. The theme of RIMPAC 2018 is “Capable, Adaptive, Partners.” Participating nations and forces will exercise a wide range of capabilities and demonstrate the inherent flexibility of maritime forces. These capabilities range from disaster relief and maritime security operations to sea control and complex warfighting. The relevant, realistic training program includes amphibious operations, gunnery, missile, anti-submarine and air defense exercises, as well as counter-piracy operations, mine clearance operations, explosive ordnance disposal, and diving and salvage operations. This year’s exercise includes forces from Australia, Brazil, Brunei, Canada, Chile, Colombia, France, Germany, India, Indonesia, Israel, Japan, Malaysia, Mexico, Netherlands, New Zealand, Peru, the Republic of Korea, the Republic of the Philippines, Singapore, Sri Lanka, Thailand, Tonga, the United Kingdom, the United States and Vietnam. This is the first time Brazil, Israel, Sri Lanka and Vietnam are participating in RIMPAC. Additional firsts include New Zealand serving as sea combat commander and Chile serving as combined force maritime component commander. This is the first time a non-founding RIMPAC nation (Chile) will hold a component commander leadership position. This year will also feature live firing of a Long Range Anti-Ship Missile (LRASM) from a U.S. Air Force aircraft, surface to ship missiles by the Japan Ground Self-Defense Force, and a Naval Strike Missile (NSM) from a launcher on the back of a Palletized Load System (PLS) by the U.S. Army. This marks the first time a land based unit will participate in the live fire event during RIMPAC. RIMPAC 18 will also include international band engagements and highlight fleet innovation during an Innovation Fair. Additionally, for the first time since RIMPAC 2002, U.S. 3rd Fleet’s Command Center will relocate from San Diego to Pearl Harbor to support command and control of all 3rd Fleet forces in 3rd Fleet’s area of responsibility to include forces operating forward in the Western Pacific. The Fleet Command Center will be established at a deployable joint command and control on Hospital Point for the first part of the exercise and then transition to USS Portland (LPD 27) for the remainder of the exercise. Hosted by Commander, U.S. Pacific Fleet, RIMPAC 2018 will be led by Commander, U.S. 3rd Fleet, Vice Adm. John D. Alexander, who will serve as combined task force (CTF) commander. Royal Canadian Navy Rear Adm. Bob Auchterlonie will serve as CTF deputy commander, and Japan Maritime Self-Defense Force Rear Adm. Hideyuki Oban as CTF vice commander. Fleet Marine Force will be led by U.S. Marine Corps Brig. Gen. Mark Hashimoto. Other key leaders of the multinational force will include Commodore Pablo Niemann of Armada de Chile, who will command the maritime component, and Air Commodore Craig Heap of the Royal Australian Air Force, who will command the air component. This robust constellation of allies and partners support sustained and favorable regional balances of power that safeguard security, prosperity and the free and open international order. RIMPAC 2018 contributes to the increased lethality, resiliency and agility needed by the joint and combined force to deter and defeat aggression by major powers across all domains and levels of conflict.

***

The location of the garrison, confirmed through satellite imagery here, can possibly support a brigade-sized intercontinental ballistic missile formation.

New Delhi: China has built a new garrison in its central Sichuan province for its intercontinental ballistic missiles (ICBM) which have the capacity to cover all of India, the Indian Ocean Region as well as large parts of continental America.

On 27 May, the 10th test of the Dongfeng-41 or DF-41 (East Wind-41) ICBM, with a reported range of 12,000-15,000 km, was conducted at the Taiyuan Space Launch Center in Shanxi province. China’s PLARF, or the People’s Liberation Army Rocket Force, formerly Second Artillery Corps (SAC), claimed it a success.

Vinayak Bhat/The Print

ThePrint has now identified a never-before revealed PLARF location, which may possibly be a DF-41 garrison, with the help of satellite imagery.

ThePrint had in April reported that PLARF had built a garrison in the southernmost Hainan province to store DF-31AG missile.

The location

This is the first time that the new Chinese garrison has been confirmed through satellite imagery (as of 7 May, 2018), although it has been covered by ground human intelligence before.

It is located 15 km east of Yibin town in Sichuan province, away from towns and cities but close to a highway to enable quick deployment. Construction is said to have begun three years ago.

The entire complex can possibly support a brigade-sized ballistic missile formation.

The ICBM is likely to be armed with 10 multiple independently targetable re-entry vehicle (MIRV) warheads each with 150kT yield.

Vinayak Bhat/The Print

This new garrison is typically built around a sports track with a football field in it. It also has two basketball grounds and an obstacle course adjoining the sports track.

There are two large highbay garages in the centre of the complex along with two smaller highway garages to the north of the facility. The smaller highbay garages were probably built for warhead assembly.

There are two locations where dugouts are observed. These could possibly be underground DES igloos.

Vinayak Bhat/The Print

There are about 15 triple storied C-shaped barracks, possibly for troops’ living accommodations.

Three large multi-storey buildings connected with each other could be administrative offices. A meteorological station with possible satellite link is also seen to the west side of the complex.

All buildings except central administrative buildings and high-bay garages are provided with slanted box gable roofs.

Vinayak Bhat/The Print

The entire garrison with its support buildings has a very high-walled security with four entrances. The main entrance is heavily guarded with around 200m approach under visual observation with the help of a large convex mirror.

It has typical layout of eight garages with six of them being interconnected. There are 30 smaller buildings (15 on either side of highbay garages) with different dimensions which are difficult to assess.

In the latest satellite image, a large tractor trailer of 22m is seen plying on the highway 400 metre south of the complex, suggesting that DF-41 truck erector launcher (TEL) of similar size can easily manoeuvre in this area.

The vehicle

The DF-41 vehicle has most advanced technologies incorporated for the smooth ride of the missile. It is an eight-axle, 16-wheeled TEL with possibly a six-axle drive.

The steering mechanism of DF-41 TEL is very uniquely purposed to provide high-speed turning stability and smallest possible turning radius to the behemoth.

Power steering has been provided on the three-front steer axles and the rear three drive axles are probably mechanically coordinated with hydraulic power. Thus making the DF-41 TEL very easily manoeuvrable.

As for the 27 May ICBM test from the Taiyuan Space Launch Centre, it was first reported by Washington Free Beacon quoting Pentagon spokesman Marine Corps Lt. Col. Christopher Logan who said, “The US was aware of recent flight tests and we continue to monitor weapons development in China.”

The well-known defence magazine IHS Jane’s Defence Weekly claimed that after the latest launch, DF-41 had moved closer to commissioning and deployment. Chinese experts claim that DF-41 is the most advanced ICBM in the world.

For Those that Want to Eliminate ICE, Read This

Posted on June 28, 2018June 28, 2018 by Denise Simon

This operation goes back to at least 2017, where collaboration with several agencies and international programs began to investigate FGM.

U.S. Immigration and Customs Enforcement (ICE) Homeland Security Investigations (HSI) New York Border Enforcement Security Taskforce (BEST), with support from HSI’s Human Rights Violators War Crimes Unit (HRVWCU), has initiated Operation Limelight USA, a pilot program designed to bring awareness to Female Genital Mutilation (FGM) and deter its practice through training, outreach and enforcement.

This initiative is the U.S.based version of the United Kingdom’s Operation Limelight at Heathrow Airport conducted by the Metropolitan Police Service and Border Force.

The initiative aims to safeguard and prevent young girls from being subjected to FGM by informing passengers traveling to high-prevalence countries about the U.S. laws governing FGM and the potential criminal, immigration, and child protective consequences of transporting a child to another country for the purpose of FGM.

HSI HRVWCU intends to expand Operation Limelight USA to additional airports around the country, focusing on those airports serving the largest FGM- prevalent diaspora communities.

ICE leads effort to prevent female genital mutilation at Newark Airport

NEWARK, NJ – Starting on June 19, U.S. Immigration and Customs Enforcement’s (ICE) Homeland Security Investigations (HSI) Newark initiated Operation Limelight USA, a program designed to bring awareness to Female Genital Mutilation (FGM) and prevent young girls from being subjected to FGM by informing passengers traveling to FGM high-prevalence countries about the U.S. laws governing FGM and the potential criminal, immigration, and child protective consequences of transporting a child to another country for the purpose of FGM.

This initiative is the U.S. based version of the United Kingdom’s Operation Limelight at Heathrow Airport conducted by the Metropolitan Police Service and Border Force. The pilot program was initiated at JFK International Airport last year and was incredibly successful. HSI has expanded Operation Limelight USA to additional airports around the country, focusing on those airports serving the largest FGM- prevalent diaspora communities. The operation at Newark International Airport met with similar success.

“Our aim here is three-fold regarding this brutal practice,” said Brett Dreyer, assistant special in charge, HSI Newark, and who led the efforts for Operation Limelight at JFK Airport last year and at Newark Airport this year. “Enforcement is a key piece here, but so is outreach and prevention. This is why we have partnered with other government agencies, NGOs and, most importantly, survivors and advocates from the community to share knowledge and resources so we may collectively end this practice.”

“U.S. Customs and Border Protection is extremely proud to have assisted in this awareness program,” said Robert E. Perez, director New York Field office. “It is through collaborative efforts, such as this Female Genital Mutilation Prevention Program, that law enforcement agencies can contribute to the prevention of these serious human rights violations.”

FGM is a serious human rights violation, and a gender-specific form of child abuse. This harmful traditional practice negatively affects millions of women and girls around the world, and is concentrated in thirty-one countries in Africa, Asia and the Middle East. FGM provides no health benefits and in fact can cause lifelong consequences including chronic infection, severe complications during childbirth, mental health and even death.

HSI is in a unique position to engage with the traveling public at U.S. borders and ports of entry to focus on the prevention of “vacation cutting”, or sending children out of the United States for the purpose of FGM. As part of Operation Limelight USA, special agents, who have completed FGM-related training, speak to passengers flying to or from high-risk countries, offering informational brochures and identifying potential victims and violators of FGM. These discussions both educate passengers on the consequences of involvement in FGM and provide passengers with a means by which to refer cases or receive victim assistance.

Additionally, HSI Newark has partnered with U.S. Customs and Border Protection, the U.S. Attorney’s Office for the District of New Jersey, NJ state agencies representing children, local health practitioners, community organizations, and survivors in the fight against FGM. These partnerships reflect the necessity for a whole government approach to prevention of FGM.

Federal law, under Title 18 of United States Code (U.S.C.) §116, prohibits individuals from conducting, assisting, attempting or conspiring to conduct FGM in the United States or facilitating the international travel to perform FGM abroad on female children, under age 18. Additionally, 26 states, including New Jersey, have specifically outlawed FGM, and for the remaining 24 states, FGM would fall under existing child abuse statutes.

In April 2017, an HSI and FBI joint investigation led to the arrest of a Detroit emergency room physician who was charged with performing FGM on girls who were approximately six to eight years of age. This case, which is being prosecuted out of the U.S. Attorney’s Office for the Eastern District of Michigan, is the first case of an individual facing prosecution in the United States in violation of 18 U.S.C. §116, which criminalizes FGM.

Members of the public who have information about individuals suspected of engaging in human rights abuses, to include FGM, are urged to call the HSI tip line at – 1-866-DHS-2423 (1-866-347-2423). Callers may remain anonymous. To learn more about the assistance available to victims in these cases, the public should contact the confidential victim-witness toll-free number at 1-866-872-4973. You can learn more about HSI’s mission to enforce federal laws governing border control, customs, trade and immigration to promote homeland security and public safety at www.ICE.gov.

601 Charged in $2 Billion in Healthcare Fraud

Posted on June 28, 2018June 28, 2018 by Denise Simon

Department of Justice

Office of Public Affairs

FOR IMMEDIATE RELEASE

Thursday, June 28, 2018

National Health Care Fraud Takedown Results in Charges Against 601 Individuals Responsible for Over $2 Billion in Fraud Losses

Largest Health Care Fraud Enforcement Action in Department of Justice History Resulted in 76 Doctors Charged and 84 Opioid Cases Involving More Than 13 Million Illegal Dosages of Opioids

Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Alex M. Azar III, announced today the largest ever health care fraud enforcement action involving 601 charged defendants across 58 federal districts, including 165 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving more than $2 billion in false billings. Of those charged, 162 defendants, including 76 doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty state Medicaid Fraud Control Units also participated in today’s arrests. In addition, HHS announced today that from July 2017 to the present, it has excluded 2,700 individuals from participation in Medicare, Medicaid, and all other Federal health care programs, which includes 587 providers excluded for conduct related to opioid diversion and abuse.

Attorney General Sessions and Secretary Azar were joined in the announcement by Acting Assistant Attorney General John P. Cronan of the Justice Department’s Criminal Division, Deputy Director David L. Bowdich of the FBI, Assistant Administrator John Martin of the Drug Enforcement Administration (DEA), Deputy Inspector General Gary Cantrell of the HHS Office of Inspector General (OIG), Deputy Chief Eric Hylton of IRS Criminal Investigation (CI), Centers for Medicare and Medicaid Services (CMS) Deputy Administrator and Director of the Center for Program Integrity Alec Alexander and Director Dermot F. O’Reilly of the Defense Criminal Investigative Service (DCIS).

Today’s enforcement actions were led and coordinated by the Criminal Division, Fraud Section’s Health Care Fraud Unit in conjunction with its Medicare Fraud Strike Force (MFSF) partners, a partnership between the Criminal Division, U.S. Attorney’s Offices, the FBI and HHS-OIG. In addition, the operation includes the participation of the DEA, DCIS, IRS-CI, Department of Labor, other various federal law enforcement agencies, and State Medicaid Fraud Control Units.

The charges announced today aggressively target schemes billing Medicare, Medicaid, TRICARE (a health insurance program for members and veterans of the armed forces and their families), 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 involved in the unlawful distribution of opioids and other prescription narcotics, a particular focus for the Department. According to the CDC, approximately 115 Americans die every day of an opioid-related overdose.

“Health care fraud is a betrayal of vulnerable patients, and often it is theft from the taxpayer,” said Attorney General Sessions. “In many cases, doctors, nurses, and pharmacists take advantage of people suffering from drug addiction in order to line their pockets. These are despicable crimes. That’s why this Department of Justice has taken historic new steps to go after fraudsters, including hiring more prosecutors and leveraging the power of data analytics. Today the Department of Justice is announcing the largest health care fraud enforcement action in American history. This is the most fraud, the most defendants, and the most doctors ever charged in a single operation—and we have evidence that our ongoing work has stopped or prevented billions of dollars’ worth of fraud. I want to thank our fabulous partners with the FBI, DEA, our Health Care Fraud task forces, HHS, the Defense Criminal Investigative Service, IRS Criminal Investigation, Medicare, and especially the more than 1,000 federal, state, local, and tribal law enforcement officers from across America who made this possible. By every measure we are more effective at finding and prosecuting medical fraud than ever.”

“Every dollar recovered in this year’s operation represents not just a taxpayer’s hard-earned money—it’s a dollar that can go toward providing healthcare for Americans in need,” said HHS Secretary Azar. “This year’s Takedown Day is a significant accomplishment for the American people, and every public servant involved should be proud of their work.”

According to court documents, the defendants allegedly participated in schemes to submit claims to Medicare, Medicaid, TRICARE, and private insurance companies for treatments that were medically unnecessary and often never provided. In many cases, patient recruiters, beneficiaries and other co-conspirators were allegedly paid cash kickbacks in return for supplying beneficiary information to providers, so that the providers could then submit fraudulent bills to Medicare. Collectively, the doctors, nurses, licensed medical professionals, health care company owners and others charged are accused of submitting a total of over $2 billion in fraudulent billings. The number of medical professionals charged is particularly significant, because virtually every health care fraud scheme requires a corrupt medical professional to be involved in order for Medicare or Medicaid to pay the fraudulent claims. Aggressively pursuing corrupt medical professionals not only has a deterrent effect on other medical professionals, but also ensures that their licenses can no longer be used to bilk the system.

“Healthcare fraud touches every corner of the United States and not only costs taxpayers money, but also can have deadly consequences,” said FBI Deputy Director Bowdich. “Through investigations across the country, we have seen medical professionals putting greed above their patients’ well-being and trusted doctors fanning the flames of the opioid crisis. I want to thank the agents, analysts and our law enforcement partners in every field office who work each and every day to stop these criminals and hold them accountable for their actions.”

“DEA is committed to ending the opioid crisis occurring in our communities and preventing prescription drug misuse,” said DEA Assistant Administrator Martin. “DEA will continue to work with our partners every day to protect our citizens while ensuring that patients have adequate access to these critical medications.”

“This year’s operations, focusing on opioid-related schemes, spotlight the far-reaching impact of health care fraud,” said HHS Deputy Inspector General Cantrell. “Such crimes threaten the vitally important Medicare and Medicaid programs and the beneficiaries they serve. Though we have made significant progress in our fight against health care fraud; our efforts are not complete. We will continue to work with our partners to protect the health and safety of millions of Americans.”

“It takes a special kind of person to prey on the sick and vulnerable as happened in many of these health care fraud schemes,” said Deputy Chief Hylton. “Medical professionals and others callously placed individuals and vital healthcare services in harm’s way simply because of greed. IRS-CI special agents continue to work side-by-side with other federal, state and local law enforcement officers to uncover these schemes and hold these criminals accountable for their actions.”

“CMS makes it a top priority to protect the health and safety of millions of beneficiaries who depend on vital federal healthcare programs,” said Alec Alexander, deputy administrator and director of the Center for Program Integrity. “CMS’ Center for Program Integrity collaborates closely with our law enforcement partners to safeguard precious taxpayer dollars. Under Administrator Seema Verma, we will continue to strengthen this partnership with law enforcement in order to ensure the integrity and sustainability of these essential programs that serve millions of Americans.”

“Heath care fraud wounds our service members and veterans alike, as they rely upon and rightfully expect uncompromised care through the Department of Defense’s TRICARE Program,” said DCIS Director O’Reilly. “Investigations that culminated in enforcement actions over the past several days underscore the steadfast commitment of the Defense Criminal Investigative Service and our investigative partners to vigorously investigate fraud impacting TRICARE. We remain vigilant in our efforts to ensure the high standards of care our service members, military retirees, and their dependents deserve while safeguarding American taxpayer dollars.”

The Medicare Fraud Strike Force operations are part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. The Medicare Fraud Strike Force operates in 10 locations nationwide. Since its inception in March 2007, the Medicare Fraud Strike Force has charged over 3,700 defendants who collectively have falsely billed the Medicare program for over $14 billion.

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For the Strike Force locations, in the Southern District of Florida, 124 defendants were charged with offenses relating to their participation in various fraud schemes involving over $337 million in false billings for services including home health care and pharmacy fraud. In one case, an owner, medical director, and two employees of a sober living facility were charged with conspiracy to commit health care and wire fraud, substantive counts of health care fraud, and substantive counts of money laundering. The indictment alleges a scheme that illegally recruited patients, paid kickbacks, and defrauded health care benefit programs for widespread fraudulent urine testing. During the course of the fraudulent scheme, the facility submitted more than $106 million in claims for substance abuse treatment services.

In the Central District of California, 33 defendants were charged for their roles in schemes to defraud insurance programs out of more than $660 million. For example, one indictment in a compounding pharmacy fraud case alleges an attorney/marketer paid kickbacks and offered incentives such as prostitutes and expensive meals to two podiatrists in exchange for prescriptions written on pre-printed prescription pads, regardless of the medical need for the prescriptions. Once the prescriptions were filled, members of the conspiracy submitted approximately $250 million in fraudulent claims to federal, state, and private insurers for the compounded drugs.

In the Southern District of Texas, 48 individuals were charged in cases involving more than $291 million in alleged fraud. Among these defendants are a pharmacy chain owner, managing partner, and lead pharmacist charged with a drug and money laundering conspiracy. According to the indictment, the coconspirators used fraudulent prescriptions to fill bulk orders for over one million pills of hydrocodone and oxycodone, which the pharmacy, in turn, sold to drug couriers for millions of dollars. In the Northern District of Texas, a home health agency owner was arrested on a criminal complaint for a $2.6 million health care fraud scheme.

In the Eastern District of Michigan, 35 defendants face charges for their alleged roles in fraud, kickback, money laundering and drug diversion schemes involving approximately $197 million in false claims for services that were medically unnecessary or never rendered. In one case, a physician was charged in separate kickback conspiracies with two home health agency owners, which resulted in more than $12 million in fraudulent insurance billings.

In the Northern District of Illinois, 21 individuals were charged for various fraud schemes involving home health and dental services. These schemes involved allegedly over $54 million in fraudulent billing. One case alleges a home health fraud and kickback conspiracy, which resulted in more than $6.2 million paid by Medicare based on the fraudulent billings.

In the Eastern District of New York, 13 individuals were charged with participating in a variety of schemes including kickbacks, services not rendered, identity theft and money laundering involving over $38 million in fraudulent billings. For example, the owner of a Brooklyn ambulette company was charged in a $7 million conspiracy stemming from the alleged payment of kickbacks for the referral of patients, who subjected themselves to purported physical and occupational therapy and other services, and were transported by the ambulette company.

In the Middle District of Florida, 21 individuals were charged with participating in a variety of schemes involving more than $21 million in fraudulent billings. In one case, a physician and clinic owner were charged with a conspiracy to defraud Medicare of more than $2.8 million for fraudulent home health billings.

In the Southern Louisiana Strike Force, operating in the Middle and Eastern Districts of Louisiana as well as the Southern District of Mississippi, 42 defendants were charged in connection with health care fraud, drug diversion, and money laundering schemes involving more than $16 million in fraudulent billings. One case alleges that three pharmacy owners and a nurse practitioner conspired to unlawfully dispense controlled substances and defraud TRICARE and private insurance companies out of $12 million.

In the Corporate Strike Force, five defendants were charged in the Middle District of Tennessee with a kickback conspiracy at a durable medical equipment company, which allegedly resulted in more than $1 million in kickbacks and over $2.5 million in fraudulent billings to Medicare.

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In addition to the Strike Force locations, today’s enforcement actions include cases and investigations brought by an additional 46 U.S. Attorney’s Offices, including the execution of search warrants in various investigations conducted by the Central and Northern Districts of California, Middle District of Florida, Southern District of Georgia, Western District of Kentucky, Eastern District of Michigan, Western District of North Carolina, Eastern and Western Districts of Texas, Eastern and Western Districts of Virginia, and Western District of Washington.

In the Northern and Southern Districts of Alabama, 15 defendants were charged for their roles in eight health care fraud schemes involving compounding pharmacy fraud and unlawful distribution of controlled substances.

In the Eastern District of California, four defendants were charged for their roles in two health care fraud schemes, one of which included forged prescriptions.

In the Southern District of California, seven defendants, including a physician, were charged for their roles in three health care fraud schemes and one scheme involving identity theft and services that were not rendered.

In the District of Colorado, a defendant was charged with health care fraud related to billings to Medicaid and Medicare.

In the District of Connecticut, three defendants, including two medical professionals, were charged for their roles in two schemes involving compounding drugs and unlawful distribution of Schedule II and IV controlled substances.

In the District of Delaware, a physician/owner of a pain management clinic was charged with unlawfully prescribing more than two million dosage units of Oxycodone products.

In the District of Columbia, a durable medical equipment company owner was charged with defrauding Medicaid of $9.8 million.

In the Northern District of Florida, four defendants were charged in a scheme to defraud TRICARE and other private insurance companies out of over $8 million for medically unnecessary compounded creams and pills.

In the Northern, Middle, and Southern Districts of Georgia, 12 defendants, including two physicians, were charged in nine health care fraud, drug diversion, or compounding pharmacy schemes involving over $13.5 million in fraudulent billings.

In the District of Idaho, three defendants, all of who are medical professionals, were charged for their roles in three separate fraud schemes involving controlled substances.

In the Central and Southern Districts of Illinois, seven defendants were charged in six separate schemes to defraud the Medicaid program.

In the Northern District of Indiana, eight defendants were charged in various health care fraud schemes to defraud both the Medicare and Medicaid programs.

In the Northern District of Iowa, two defendants – both medical professionals – were charged for their roles in two opioid-related schemes.

In the Districts of Kansas and the Northern and Western Districts of Oklahoma, 12 defendants, including four physicians, were charged in various unlawful distribution of controlled substances schemes. In the Western District of Oklahoma, one case marks the district’s first time charging unlawful distribution of controlled substances resulting in a death.

In the Eastern and Western Districts of Kentucky, 12 defendants, including five medical professionals, were charged in various schemes involving health care fraud, unlawful distribution of controlled substances, aggravated identity theft, and money laundering. One case involved the operation of two false-front medical clinics.

In the Districts of Maine and Vermont, two defendants were charged for their roles in two schemes to defraud various government programs including Medicare, Medicaid, and ones run by the HHS’ Administration for Children and Families.

In the District of Nebraska, seven defendants, including one physician, were charged in five separate schemes to defraud Medicare, Medicaid, and various HHS programs.

In the District of Nevada, four defendants, including three medical professionals were charged with conspiracies to commit health care fraud and distribute controlled substances.

In the District of New Jersey, eight defendants, including a New York doctor, an anesthesiology technologist for a Philadelphia hospital, and the owner of a medical billing company, were charged for their roles in five schemes to defraud private insurance companies of over $16 million.

In the Southern District of New York, two defendants were charged in schemes involving health care fraud or drug diversion.

In the Middle District of North Carolina, two defendants were charged with a conspiracy to defraud Medicare out of over $4 million.

In the Southern District of Ohio, three defendants – all medical professionals – were charged for their roles in two health care fraud schemes, one of which involved illegal drug distribution and kickbacks.

In the Eastern and Middle Districts of Pennsylvania, 12 defendants were charged for their roles in three drug diversion schemes.

In the Western District of Pennsylvania, four defendants – all physicians – were charged in various health care fraud and drug diversion schemes. One scheme involved 32,000 dosage units of buprenorphine.

In the District of Rhode Island, one defendant was charged for participating in a theft and aggravated identity theft scheme.

In the District of South Carolina, three defendants were charged for their separate roles in a conspiracy to possess with the intent to distribute fentanyl.

In the District of South Dakota, two defendants were charged in separate cases, one of which involved a scheme to defraud the Indian Health Service.

In the Middle District of Tennessee, 10 defendants were charged in two separate schemes, including a conspiracy to fraudulently obtain oxycodone.

In the Eastern District of Texas, two defendants were charged for their role in health care fraud schemes to defraud the Medicare and Medicaid programs.

In the District of Utah, two defendants were charged in two cases, one of which involved a $31 million scheme to defraud Medicare and Medicaid.

In the Western District of Virginia, eight defendants were charged for their alleged roles in health care fraud schemes. One $45 million scheme to defraud Medicaid involved falsification of documents in patient files.

In the Eastern District of Washington, a dentist and another individual were indicted for distributing and conspiring to distribute hydrocodone and tramadol without a legitimate medical purpose.

In the Eastern District of Wisconsin, three defendants were charged in a scheme involving the unlawful distribution of controlled substances and aggravated identity theft.

In addition, in the states of Arizona, Arkansas, California, Connecticut, Delaware, Florida, Hawaii, Illinois, Indiana, Kansas, Louisiana, Maine, Michigan, Missouri, Mississippi, Nevada, New York, Oklahoma, Pennsylvania, Texas, Vermont, and Washington, 97 defendants have been charged with defrauding the Medicaid program out of over $27 million. These cases were investigated by each state’s respective Medicaid Fraud Control Units. In addition, the Medicaid Fraud Control Units of the states of California, District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Nevada, North Carolina, Ohio, Texas, Tennessee, and Virginia participated in the investigation of many of the federal cases discussed above.

The cases announced today are being prosecuted and investigated by U.S. Attorney’s Offices nationwide, along with Medicare Fraud Strike Force teams from the Criminal Division’s Fraud Section and from the U.S. Attorney’s Offices in the Southern District of Florida, Eastern District of Michigan, Eastern District of New York, Southern District of Texas, Central District of California, Eastern District of Louisiana, Northern District of Texas, Northern District of Illinois, Middle District of Louisiana, and the Middle District of Florida; and agents from the FBI, HHS-OIG, DEA, DCIS, IRS-CI, Department of Labor, other various federal law enforcement agencies, and state Medicaid Fraud Control Units.

A complaint, information, or indictment is merely an allegation, and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.

Additional documents related to this announcement will shortly be available here:

https://www.justice.gov/opa/documents-and-resources-june-28-2018.

This operation also highlights the great work being done by the Department of Justice’s Civil Division. In the past fiscal year, the Department of Justice, including the Civil Division, has collectively won or negotiated over $2 billion in judgements and settlements related to matters alleging health care fraud.