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Government Announces Health Care Fraud “Takedown”

Earlier today, Attorney General Loretta Lynch announced the largest coordinated crackdown in the Medicare Fraud Strike Force’s eight-year history.  The government brought charges against 243 individuals for approximately $712 million in alleged Medicare fraud.

The government alleges a wide array of misconduct ranging from conspiracy to commit health-care fraud, violations of the Anti-Kickback Statute, money laundering, and aggravated identity theft. The individuals charged include doctors, nurses, patient recruiters, home health care providers, pharmacy owners, and other license medical professionals. Notably, almost 50 of these individuals were charged with fraud related to the Medicare prescription drug benefit program (“Part D”).

The Medicare Fraud Strike Force is a joint initiative of the Departments of Justice and Health and Human Services comprising federal, state and local law enforcement from across the country. In conjunction with the charges brought by this unit, the Centers for Medicare and Medicaid Services (“CMS”) announced that it also suspended payment to a number of providers under the suspension authority granted to the agency under the Affordable Care Act.

This coordinated “takedown” is another example of the government’s intense focus on health care fraud, waste, and abuse and the ever-growing coordination between and among federal and state health care enforcement agencies. Additionally, the takedown's highly publicized nature is designed to send a message about the government’s resolve and resources to tackle health care fraud.

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Authors

Brian P. Dunphy is a member of the Health Care Enforcement & Investigations Group at Mintz. He defends clients facing government investigations and whistleblower complaints regarding alleged violations of the federal False Claims Act. Brian also handles commercial health care litigation.
Bridgette A. Keller is a Mintz attorney who applies her experience in health system administration and ethics in health care to her health law practice. She advises health care providers, ACOs, health plans, PBMs, and laboratories on regulatory, fraud and abuse, and business planning matters.