Medicare Fraud Strike Force Created in New Jersey and Pennsylvania to Combat Health Care Fraud and Opioid Abuse

In an effort to combat Medicare fraud and its contribution to the opioid crisis, the Justice Department’s Criminal Division, the U.S. Attorney’s Offices for the District of New Jersey and the Eastern District of Pennsylvania, as well as other U.S. law enforcement agencies, announced the creation of the Newark/Philadelphia Regional Medicare Fraud Strike Force on August 13, 2018. “According to the CDC,” said Assistant Attorney General Brian A. Benczkowski, “in 2016, more than 40 percent of all U.S. opioid overdose deaths involved a prescription opioid.” Benczkowski noted that the newly created Regional Strike Force is the latest expansion of DOJ’s Medicare Fraud Strike Forces, of which there are already 10 across the United States.

The Regional Strike Force, which will investigate cases involving fraud, waste and abuse within the federal health care system, will be comprised of prosecutors and analysts from the Health Care Fraud Unit of DOJ’s Criminal Fraud Section, prosecutors from the U.S. Attorney’s Offices in New Jersey and the Eastern District of Pennsylvania, as well as agents from the FBI, DEA and Department of Health and Human Services Office of Inspector General. U.S. Attorney for the District of New Jersey, Craig Carpenito, noted that “[t]he 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.” Carpenito noted that the new Regional Strike Force supplements an already existing Health Care and Government Fraud Unit and a recently-created Opioids Unit.

Prior to this announcement, there were Medicare Fraud Strike Forces in Miami, Los Angeles, Detroit, Houston, Brooklyn, Baton Rouge, New Orleans, Tampa, Chicago and Dallas, along with a Corporate Strike Force in Washington, D.C. Since its inception in March 2007, prosecutors in the 10 Medicare Fraud Strike Force locations have charged more than 3,700 defendants who have collectively falsely billed the Medicare program for more than $14 billion.

The creation of the Strike Force follows the establishment of an Affirmative Civil Enforcement (ACE) Strike Force in the Eastern District of Pennsylvania designed to investigate and prosecute the abuse of government programs. The ACE Strike Force, which will be part of the Eastern District of Pennsylvania’s civil division, along with the Medicare Strike Force, are further examples of prosecutors in the Mid-Atlantic region taking proactive measures in an effort to confront abuse of government programs, particularly those relating to the fraudulent procurement of opioids. “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. With more resources, of course, we should anticipate more prosecutions and enforcement actions.