DOJ expands Medicare Fraud Strike Force to Newark and Philadelphia

Healthcare fraud has fueled the opioid epidemic in eastern Pennsylvania and New Jersey in a way that is "staggering," said assistant attorney general Brian Benczkowski. (Getty Images/digicomphoto)

The Department of Justice (DOJ) is adding several more cities to its Medicare Fraud Strike Force, a federal program that targets cities with high rates of fraud, waste and abuse. 

A new regional division will be based in Philadelphia and Newark, New Jersey, the agency announced Monday. 

The number of opioids prescribed per capita is notably high in New Jersey and Pennsylvania, according to Nicole Navas Oxman, a spokesperson for the DOJ.

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The DOJ will work with U.S. Attorney’s Offices for the District of New Jersey and the Eastern District of Pennsylvania—as well as the FBI, the Office of the Inspector General at the Department of Health and Human Services and the Drug Enforcement Administration—to prosecute doctors, nurses and other licensed medical professionals for false billing schemes and the illegal prescription and distribution of dangerous narcotics.

In June, the DOJ announced its largest healthcare fraud action ever, charging more than 600 individuals in fraud schemes totaling $2 billion in losses to the federal government. Most of these cases involved opioid distribution, and the Strike Force seems to be continuing that focus.

RELATED: DOJ charges more than 600 in historic fraud takedown involving $2B in false claims

The new task force adds to the administration's ongoing focus on opioid-prescribing enforcement. Brian Benczkowski, assistant attorney general for the Criminal Division of the DOJ, said in the press release the opioid epidemic in the mid-Atlantic region is “staggering—and health care fraud has played a role in feeding that epidemic.”

Craig Carpenito, U.S. attorney for the District of New Jersey, highlighted several healthcare fraud cases his office has handled recently during a press event in Newark, including one where a pharmacist distributed opioids from “pill mills.”

The District of New Jersey and the Eastern District of Pennsylvania both launched opioid task forces earlier this year.

However, the Strike Force will combat other forms of fraud as well, including compounding pharmacies, bribery, kickbacks and other illegal schemes. The program, created in 2007, has been lauded for its fraud enforcement, use of data analytics and collaboration between federal and state agencies.  

RELATED: HHS recovered $2.6B from healthcare fraud in 2017, down 21% from the previous year

Fraud is a significant reason healthcare programs, including Medicare, have skyrocketed in cost and comprise an ever-increasing share of the federal budget, Carpenito noted.

Medicare Fraud Strike Forces operate in 10 other cities across the country: Baton Rouge/New Orleans, Chicago, Dallas, Detroit, Houston, Los Angeles, New York, Tampa and Washington, D.C.

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