New Strike Force To Combat Health Care Fraud

Aug 13, 2018

Officials announce formation of the strike force.

A new strike force is bringing federal resources to the New Jersey/Philadelphia region to combat health care fraud.

Assistant U-S Attorney General Brian Benczkowski says the strike force has two purposes.

“To tackle increased waste fraud and abuse within our federal health care programs which cause the cost of Medicare and Medicaid to skyrocket. And second and perhaps more importantly to address the epidemic of prescription drug overdoses and opioid involved deaths ravaging communities across our country including here in New Jersey.”

Two federal prosecutors will be assigned to the region to help with those investigations.

Sandra Moser is the acting chief of the federal Justice Department’s fraud unit. She says a data analytics team in Washington can rapidly identify instances of potential fraud by medical providers who perform a high number of procedures that reimburse at an incredibly high rate.

“The fraudsters know to go after and identify what the highest reimbursable rates are, and they generally are not great at stopping themselves and showing moderation. So we look for those patterns, those outliers.”

Craig Carpenito, the U-S Attorney in New Jersey, says the task force will enable his office to do a better job in prosecuting those cases.

“We just have more resources to dedicate to the cause. As opposed to having to having to prioritize cases with a smaller number of prosecutors, we’re going to be able to work cases faster and we’re going to be able to work cases at the same time.”

Federal officials say similar strike forces in 10 other parts of the country resulted in charges against 3700 defendants who falsely billed the Medicare program for more than $14 billion.