The Medicare Fraud Strike Force initiated its largest ever healthcare enforcement action, charging 412 defendants in July 2017 with approximately $1.3 billion in fraudulent claims. The Strike Force consists of teams that include the Office of Inspector General, the Department of Justice, Offices of the United States Attorneys, the Federal Bureau of Investigation, and local law enforcement, with efforts concentrated in South Florida, Illinois, New York, Texas, Michigan, California, and Louisiana.
The focus of this year’s Strike Force actions is the opioid epidemic and medical professionals unlawfully distributing prescription narcotics. As part of this latest initiative, the indicted parties are from a varied geographic area, spanning 21 states. For example, in South Florida, an addiction treatment center that submitted $58 million in claims for drug treatment services was charged with fraud related to inducing patients to move to South Florida in exchange for kickbacks including free travel, gift cards, trips to strip clubs and casinos, and drugs. Another example is a Texas pain clinic that sees 60 patients each day, and was charged with prescribing hydrocodone that was not medically necessary. Additionally, an Illinois home health agency was charged with billing more than $7 million for home health services that were not rendered.
The Medicare Fraud Strike Force was created in 2007, and since its inception has filed more than 2,200 criminal actions for losses to the Medicare, Medicaid, and TRICARE programs. Since 2007, the Strike Force has collected over $2.5 billion from transgressors. In addition to criminal prosecutions, fraud cases are referred to CMS to suspend payments and seek to exclude providers.