Let’s Take a Look at How DOJ Task Forces Fight Fraud

Healthcare and defense, while massive, are not the government’s only expenditures susceptible to fraud. The vast array of government programs and the enormous sums expended to advance those programs means the government needs ways to efficiently and effectively root out fraud.

Oftentimes, the government attempts to do so by forming a task force to address areas of particular concern. Most recently, in May of this year, the Department of Justice launched a COVID-19 Fraud Task Force that sought to discover and punish those who would use a global tragedy to exploit government funds and harm an uneasy public.

The task force has quickly produced results. In July of this year, for instance, twenty-two individuals were charged in connection with a massive fraud scheme to obtain over $11 million in Paycheck Protection Program (PPP) funds to purchase luxury vehicles, jewelry, and other personal items.

Not surprisingly, in light of the perennial fraud on the Medicare program discussed in prior posts, the government has maintained a Medicare Fraud Strike Force since March 2007. Strike Force teams currently operate in Miami, Los Angeles, Detroit, Houston, Brooklyn, Baton Rouge, New Orleans, Tampa, Orlando, Chicago, Dallas, Newark/Philadelphia, Washington, DC, and the Appalachian Region.

Recent Strike Force enforcement efforts have targeted fraud schemes involving substance abuse treatment, durable medical equipment, prescription opioids, and home health services.

In a massive coordinated action in September 2020, 345 defendants, including more than 100 doctors, nurses, and other licensed medical professionals, were charged across 51 federal districts with submitting more than $6 billion in false and fraudulent claims to federal health care programs and private insurers, including more than $4.5 billion related to telemedicine claims, more than $845 million related to substance abuse treatment facilities, and more than $800 million related to other healthcare fraud and illegal opioid distribution schemes.

While task forces have been successful, there is still more fraud out there, underscoring the need for whistleblowers to supplement the government’s resources in combatting fraud.

Written by Molly Knobler & Talia Mermin of Phillips & Cohen, LLP