Feds reorganize to attack healthcare fraud

Stung by the extent of fraud in government healthcare programs, the Department of Justice and the Pittsburgh U.S. Attorney's office are ramping up operations to fight fraud more effectively and efficiently.

The Justice Department's criminal division will increase its scrutiny of alleged False Claims Act violations, Whistleblower Lawyer News reported. Criminal division staff will step up their analysis of whistleblower cases with an eye on potential criminal prosecution.

Though the Justice Department's civil division will still take the lead in false claims cases, the new policy will help eliminate bottlenecks in reviewing cases for possible parallel criminal investigation. This change applies an anti-fraud strike force model to corporate false claims cases in healthcare.

"The hallmark of the strike force is using data to speed up investigations and indictments, to cut down the time it takes normally to investigate," attorney Sam Sheldon, former supervisor of the Justice Department's criminal division fraud section, told Whistleblower Lawyer News. Efficiency gains are important since it's been difficult for the government to manage the volume of healthcare whistleblower lawsuits, the article added.

Moreover, criminal prosecutors have tools at their disposal to pursue these cases effectively, including the ability to obtain search warrants and wiretaps, make consensual recordings, conduct undercover operations and use confidential informants, the article noted.

In a similar vein, Pittsburgh U.S. Attorney David Hickton is committing new resources to prosecuting healthcare fraud, according to the Pittsburgh Post-Gazette. He assembled a team of four assistant U.S. attorneys backed by the FBI whose top priority will be fighting healthcare-related crime in western Pennsylvania. Hickton also asked the Office of Inspector General to post investigators in Pittsburgh.

"This is not about taking the resources of the federal government and going after small ball fraud," Hickton told the newspaper. Instead, Hickton plans to be "very aggressive in getting back dollars for the American taxpayer" by "delivering a series of very good healthcare fraud cases."

For more:
- read the Whistleblower Lawyer News article
- here's the Pittsburgh Post-Gazette article