The FBI Story by U.S. Department of Justice

Author:U.S. Department of Justice
Language: eng
Format: epub
ISBN: 9781510750579
Publisher: Skyhorse
Published: 2019-02-26T16:00:00+00:00

FBI Acting Director Andrew McCabe speaks at a July 13, 2017 press conference at the Department of Justice announcing results of a Medicare Fraud Strike Force enforcement action as HHS Secretary Tom Price (left) and Attorney General Jeff Sessions look on.

The charges—which span 41 federal districts—are the culmination of deep dives into the submissions and payment data at the federal health insurance programs, which can reveal trends and anomalies that investigators at the HHS Office of Inspector General (OIG) can then probe and send to federal, state, and local law enforcement partners to further investigate. In addition to more than 300 OIG agents, this year’s Medicare Fraud Strike Force action included 350 FBI personnel from 28 field offices. The FBI’s Health Care Fraud Unit started a Prescription Drug Initiative specifically to go after individuals who overprescribe opioids or seek to profit from illegally selling prescription narcotics.

According to the Government Accountability Office, fraud, waste, and abuse account for more than 10.8 percent of Medicare spending—or $75 billion annually.

“We will use every tool we have to stop criminals from exploiting the vulnerable people and stealing our hard-earned tax dollars,” said Attorney General Sessions. “We are sending a clear message to criminals across this country: We will find you. We will bring you to justice. And you will pay a very high price for what you have done.”

Officials laid out case examples to illustrate the scope of the alleged crimes, including:

• In Michigan, six physicians were charged with prescribing medically unnecessary controlled substances—some of which were sold on the street—and then billing Medicare for $164 million.

• In Palm Beach, Florida, the owner of an addiction treatment center was charged in a scheme to submit more than $58 million in fraudulent claims—a case that alleges kickbacks of gift cards, plane tickets, and trips to casinos and strip clubs.

• In Houston, a physician and pain management clinic owner who saw 60 to 70 clients a day allegedly issued medically unnecessary prescriptions for hydrocodone in exchange for $300 cash per visit.

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