Insurance Fraud NEWS
Assistant AG Benczkowski announces Newark/Philadelphia Medicare fraud strike force to focus on health care fraud and illegal opioid Prescriptions
August 13, 2018, Washington, DC
Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division today announced the formation of the Newark/Philadelphia Regional Medicare Fraud Strike Force (Regional Strike Force), a joint law enforcement effort that brings together the resources and expertise of the Health Care Fraud Unit in the Criminal Division’s Fraud Section (HCF Unit), the U.S. Attorney’s Offices for the District of New Jersey and the Eastern District of Pennsylvania, as well as law enforcement partners at the FBI, U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG) and U.S. Drug Enforcement Administration (DEA).
Assistant Attorney General Benczkowski was joined in the announcement by U.S. Attorney Craig Carpenito for the District of New Jersey; U.S. Attorney William M. McSwain for the Eastern District of Pennsylvania; Assistant Director Robert Johnson of the FBI’s Criminal Investigative Division; Deputy Inspector General Gary Cantrell of the Department of Health and Human Services Office of Inspector General (HHS-OIG) and Assistant Administrator John Martin (link is external) of the DEA.
“The devastation the opioid epidemic is inflicting on communities across the country and here in the Mid-Atlantic region is staggering—and health care fraud has played a role in feeding that epidemic,” said Assistant Attorney General Benczkowski. “It is estimated that each year tens of billions of dollars in American taxpayer money are lost to fraud, waste, abuse and improper payments. According to the CDC, in 2016, more than 40 percent of all U.S. opioid overdose deaths involved a prescription opioid. Our Medicare Fraud Strike Forces, which we have now expanded into Newark and Philadelphia, constitute one of our most important and effective means for containing these threats to the American people.”
“New Jersey is home to some of the best healthcare facilities and most successful pharmaceutical companies in the country,” said U.S. Attorney Carpenito. “Unfortunately, that also means that we offer substantial targets for those who would try to defraud the health care system or try to profit from the misery of people battling addiction to opioids. We’ve already developed one robust unit to go after these criminals (the Healthcare & Government Fraud Unit), and I added another (the Opioids Unit) in February upon rejoining the office as U.S. Attorney. The arrival of the Medicare Fraud Strike Force in our District will serve as an additional force-multiplier and enable us to do even more of these cases, further protecting the citizens of New Jersey from this kind of fraud and abuse.”
“Combatting the opioid epidemic and healthcare fraud abuses are major priorities of the Department of Justice and the U.S. Attorney’s Office for the Eastern District of Pennsylvania,” said U.S. Attorney McSwain. “Healthcare fraud schemes are driven by greed, and all American taxpayers pay the price for criminals who prey on providers and beneficiaries alike. My Office is honored and proud to welcome the DOJ Medicare Fraud Strike Force to our District in order to attack these problems with our law enforcement partners.”
“Healthcare fraud touches every corner of the United States and not only costs taxpayers money but can have deadly consequences; it is not a victimless crime,” said FBI Assistant Director Johnson. “Through investigations, outreach, partnerships, and education, the FBI is committed to combating health care fraud and the growing opioid epidemic that faces the United States. We look forward to the addition of the Newark/Philadelphia Regional Medicare Fraud Strike Force and continuing our work with our partners to positively impact the fight against fraud and abuse.”
“Fraudulent activity remains a significant threat to federal health care programs’ stability and the millions of beneficiaries who rely on such programs,” said HHS-OIG Deputy Inspector General Cantrell. “This joint initiative enables us to marshal resources with other law enforcement agencies, resulting in even more impressive investigative outcomes against health care fraud. As members of the Strike Force, OIG will continue to play a vital role in fighting health care fraud and holding criminals accountable.”
“DEA is committed to ending the opioid crisis occurring in our communities and preventing prescription drug misuse,” said DEA Assistant Administrator Martin (link is external). “Together with our law enforcement partners, we will work to bring down those medical professionals who seek to do harm while ensuring that patients have adequate access to critical medications.”
Prior to this announcement, the HCF Unit operated Medicare Fraud Strike Force’s in 10 cities across the United States including Miami, Florida; Los Angeles, California; Detroit, Michigan; Houston, Texas; Brooklyn, New York; Baton Rouge and New Orleans, Louisiana; Tampa, Florida; Chicago, Illinois; and Dallas, Texas, along with a Corporate Strike Force located in Washington, D.C. The Strike Forces represent a partnership between the Criminal Division, U.S. Attorney’s Offices, the FBI and HHS-OIG.
The Regional Strike Force will be made up of prosecutors and data analysts with the HCF Unit, prosecutors with the U.S. Attorney’s Offices for the District of New Jersey and Eastern District of Pennsylvania, and special agents with the FBI, HHS-OIG and DEA. In addition, the Regional Strike Force will work closely with other various federal law enforcement agencies, including the U.S. Postal Inspection Service and IRS Criminal Investigation, and State Medicaid Fraud Control Units. The Strike Force will focus its efforts on aggressively investigating and prosecuting cases involving fraud, waste, and abuse within our federal health care programs, and cases involving illegal prescribing and distribution of opioids and other dangerous narcotics.
In June, Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Alex M. Azar III noted the success of the Strike Force model while announcing 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. More information can be obtained at https://www.justice.gov/opa/documents-and-resources-june-28-2018.
The 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. Since its inception in March 2007, the prosecutors in the 10 Medicare Fraud Strike Force locations have charged over 3,700 defendants who collectively have falsely billed the Medicare program for over $14 billion.
Source: United States Department of Justice