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Medicare Fraud Strike Forces change the future of medicine

The United States Departments of Justice (DOJ) and Health and Human Services (HHS) may have begun operations for their Medicare Fraud Strike Force (MFSF) in Florida, but the scope of operations has broadened in recent years. As of 2018, the agencies now have operations open in ten cities throughout the country, including an MFSF up and running in New York.

The agencies began the operations of the MFSF unit under the guise they would seek out the worst of the worst offenders when it came to health care fraud — but has this been true?

Operations may extend beyond the worst of the worst

The strike forces have experienced a relatively rapid rate of growth. Some would argue the growth is the result of a need for assistance investigating and building cases against health care fraud crimes that were running rampant throughout the country. The fact that the strike forces have resulted in charges against over 4,000 individuals and led to the discovery of approximately $19 billion in false billing from the Medicare program may support this contention.

However, it is important to note the types of crimes the MFSF are investigating may not be what the group originally had in mind. Lately, critics of the program could argue the MFSF appears to be making the most of a provision that allows the group to target “emerging schemes” throughout the country that may not fit the definition of the “worst of the worst” of health care fraud offenders. As a result, it may be more important than ever for those who find themselves or their business the subject of a government investigation to take the matter seriously. These investigations are aggressive and can come with serious penalties. As a result, a proactive approach is often wise. Seek legal counsel to discuss your options.  

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