Printable Version

Rights/Reprints

LAW FIRMS

• Patton Boggs LLP

Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius at an earlier news conference. (photo by Ryan Reilly / Main Justice)

Attorney General Eric Holder and Department of Health and Human Services Secretary Kathleen Sebelius announced the largest enforcement action in the short history of the Medicare Fraud Strike Force teams Friday in Miami– a sweeping, four city round up of 94 defendants who allegedly bilked the government health care program out of $251 million.

As early as 6 a.m. Friday, federal and state law enforcement agents began arresting suspects and executing search warrants. In total, 360 agents, primarily from the FBI and HHS, executed eight search warrants as a part of ongoing investigations and arrested defendants in Miami, Detroit, Baton Rouge, La., and Brooklyn.

Of the 94 charged defendants, 36 have been arrested so far.

“With today’s arrests, we’re putting would-be criminals on notice: Health care fraud is no longer a safe bet,” Holder said in a news release. “It’s no longer easy money. If you choose to engage in health care fraud, you will be found; you will be stopped; and you will be brought to justice.”

While no reliable measurement of health care fraud exists, the Justice Department places annual losses in the billions of dollars. Against the backdrop of multitrillion dollar health care legislation, the Obama administration has asked for $90 million in fiscal 2011 — an increase of $60 million — to fight the scourge. More than half of that amount would cover costs of expanding health care strike forces in as many as 13 new cities.

The strike forces, which are supervised by HHS and the Criminal Division’s Fraud, working in close contact with the local U.S. Attorney’s offices, serve as on the ground presence to target and prosecute health care fraud.

The first strike force, in Miami, began work in 2007, and the initiative also has strong footholds in Detroit and Houston. But today’s operation served as a coming out party for the teams in Brooklyn and Baton Rouge. In May 2009, the Justice Department expanded the strike forces to become Health Care Fraud Prevention and Enforcement Action Teams, known as HEAT teams.

“This diverse group of cities illustrates the department’s commitment to continuing to fight fraud in places where strike forces have existed for some time, but also shows the willingness of the department to simultaneously expand into other areas,” said Jay Darden, a former assistant chief on the Fraud Section’s health care fraud team and now a partner at Patton Boggs LLP.

The decision to expand the scope of the strike forces is based on the teams’ successes in places like Los Angeles and Miami. While testifying before Congress in March, Deputy Attorney General Gary Grindler said that since the strike force began targeting fraud in the durable medical equipment market in Miami, DME claim submissions dropped by $1.74 billion in the strike force’s first 12 months. Grindler also said that for every $1 spent on enforcement since 1996, $4 were returned to the Medicare trust fund.

Today’s takedown was the first since a new regime took over at the Fraud Section. Since January, former Fraud Section Chief Steve Tyrrell has been replaced by Denis McInerney, Deputy Chief for health care fraud Kirk Ogrosky has been replaced by Hank Bond Walther, while John Neal has stepped in for Darden. The program’s continuity is indicative of the department’s commitment to it, current and former officials said.