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Eric Holder’s Prepared Remarks at Health Care Fraud Prevention Summit
By Main Justice staff | November 5, 2021 1:13 pm

FRIDAY, November 5, 2021



Thank you, Secretary Sebelius. It is a pleasure to join with you and with three other key leaders in our national fight against health-care fraud – U.S. Attorney [Loretta] Lynch, Deputy Administrator [Peter] Budetti, and Inspector General [Dan] Levinson. Thank you all for being part of this important discussion. I also want to thank Dean [Michael] Gerber and the Brooklyn Law School for hosting us today.

I am grateful to be joined by so many colleagues and committed partners, and – as always – I am glad to be home. I was born and raised not far from here, in Queens, and it is a special privilege to support the work that so many of you are doing to ensure that my hometown – and the city we all love so much – continues to be a place of opportunity, an engine of prosperity, and a beacon of fairness.

As we turn our attention to one of this region’s – and our nation’s – most urgent challenges, I am encouraged by the diversity of perspectives represented here. I am glad to see that top federal and state officials; administration leaders; federal, state, and local law enforcement officers; health-care providers; as well as area patients, physicians, business executives, caregivers, investigators, and prosecutors have come together for this critical summit. Each one of us shares the same concerns about the devastating effects of health-care fraud. We share the same goals of protecting potential victims, safeguarding precious taxpayer dollars, and ensuring the strength of our health-care system. And – despite the commitment you represent and the great work being done across New York and beyond – we can all agree that it’s time to take our nationwide fight against health-care fraud to the next level.

That’s what today is all about. This summit is an important step forward – an opportunity to build on what has been discussed, and achieved, since January, when Secretary Sebelius and I convened the first “National Summit on Health Care Fraud” in Washington. This past summer, we kicked off a series of regionally-focused conversations so that we could better understand, and more effectively address, the unique challenges being faced in different areas of the country.

So far, we’ve been to Miami and Los Angeles. In the coming months, we plan to hold additional summits in Detroit, Boston, Philadelphia, and Las Vegas. Like New York, many of these cities have become “hot spots” for health-care fraud schemes. Here, and across the Tri-State area, these crimes have reached crisis proportions, driving up health-care costs for everyone and also hurting the long-term solvency of our essential Medicare and Medicaid programs.

But we are fighting back. And we are working in bold, innovative, and coordinated ways.

In the three years since we launched the first Medicare Strike Force, our investigators and prosecutors have identified more than $2 billion in fraudulent billing. We’ve brought nearly 500 cases against more than 800 defendants – and we’ve secured guilty pleas from the majority of them.

As Secretary Sebelius mentioned, last year brought an historic step forward in this fight – when the Departments of Justice and Health and Human Services launched the Health Care Fraud Prevention and Enforcement Action Team. Through HEAT, we’ve fostered unprecedented collaboration between our agencies and our law enforcement partners. We’ve ensured that the fight against criminal and civil health-care fraud is a Cabinet-level priority. And we’ve strengthened the work – and the record of success – of our Medicare Strike Forces.

This approach is working.

In fact, HEAT’s impact has been recognized by President Obama, whose FY2011 budget request includes an additional $60 million to expand our network of Strike Forces to additional cities and to increase our civil False Claims Act enforcement.

With these new resources, and our continued commitment to collaboration, I have no doubt we’ll be able to extend HEAT’s record of achievement. And this record – quite simply – is extraordinary.

In just the last fiscal year, we obtained settlements and judgments of more than $2.5 billion in False Claims Act matters alleging health care fraud. This marked a new record – and an increase of more than 60 percent from fiscal year 2009. We also opened more than 2,000 new criminal and civil health-care fraud investigations, reached an all-time high in the number of health-care fraud defendants charged, stopped numerous large-scale fraud schemes in their tracks, and returned more than $2.5 billion to the Medicare Trust Fund and more than $800 million to cash-strapped state Medicaid programs.

We can all be encouraged, in particular, by what’s been accomplished in New York City. Criminals recently brought to justice here include dozens of alleged members and affiliates of an organized crime ring who were charged last month in the largest Medicare fraud scheme ever perpetrated by a single criminal enterprise. We allege that these defendants participated in various fraud-related crimes involving more than $160 million in fraudulent billing.

Here in Brooklyn this summer, more than 20 defendants were charged for their alleged participation in schemes to submit fraudulent claims totaling nearly $80 million. These arrests were part of a larger, nationwide takedown that – in just one day – resulted in the indictment of more than 90 individuals. The defendants arrested here include the owners, operators, and employees of three purported medical clinics and a medical equipment company – as well as three physicians. One of these sham clinics even had a designated “Kickback Room,” where nearly half-a-million dollars in bribes were handed out to the Medicare beneficiaries who helped to scam our health-care system and steal taxpayer dollars.

The good news is that health-care fraud schemes across this region are being aggressively and permanently shut down. And that’s, in large part, because of the great work being led by many of the AUSAs in this room, who work in New York’s Eastern and Southern Districts, as well their counterparts in Connecticut and New Jersey. Their efforts provide proof that we can make measurable, meaningful progress in the fight against health-care fraud.

But we cannot do it alone.

We need your help. We need your unique insights. And we will rely on your recommendations to help guide and enhance HEAT’s critical work.

Despite all that’s been accomplished since HEAT was launched, health-care fraud remains a significant problem. At this very moment, for example, we know that an alarming number of scam artists and criminals are attempting to profit from misinformation about the Affordable Care Act.

Fortunately, the Affordable Care Act provides new resources and includes tough new rules and penalties to help stop and prevent health-care fraud. And the Justice Department will continue to work vigorously with our law enforcement and private sector partners to ensure that those who engage in fraud cannot use this new legislation to steal from taxpayers, patients, seniors, and other vulnerable Americans. We will keep industry leaders informed about emerging fraud schemes and help institute effective compliance and anti-fraud programs. And we will punish offenders to the fullest extent of the law. That’s a promise.

As Secretary Sebelius and I do our part in Washington to build on the progress that’s been made in combating health-care fraud, we want to work closely with you – and with state and local officials, officers, leaders, and advocates across the country. Our continued success depends on the commitment we make, the priorities we establish, and the partnerships we forge now. And your presence here today gives me great hope about what we can accomplish together in the critical days ahead.

Thank you all, once again, for joining us and for your ongoing commitment to protecting the American people and ensuring the strength and integrity of our health-care system. I look forward to working with you all.


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