Regional Medicare Fraud Strike Force Launched and Additional Federal Prosecutors Assigned to Philadelphia

PHILADELPHIA – United States Attorney William M. McSwain and Assistant Attorney General Brian A. Benczkowski of the U.S. Justice Department’s Criminal Division announced today the formation of the Newark/Philadelphia Regional Medicare Fraud Strike Force.  The Strike Force will bring together the resources and expertise of prosecutors, data analysts, and law enforcement agencies to investigate and prosecute cases involving fraud, waste, and abuse within our federal healthcare programs and cases involving illegal prescribing and distribution of opioids and other dangerous narcotics.  In addition to the information sharing and resource coordination the Strike Force will bring to bear on these complex matters, the Eastern District of Pennsylvania will add two additional attorneys to its ranks who will focus entirely on these matters.

The prosecutors assigned to the Eastern District of Pennsylvania come from the Health Care Fraud Unit in the U.S. Justice Department’s Criminal Division’s Fraud Section, where they have gained a wealth of subject-matter expertise.  The federal investigative agencies and state partners participating in the Strike Force include Department of Health and Human Services Office of Inspector General (HHS-OIG); Drug Enforcement Administration (DEA); Federal Bureau of Investigation (FBI); U.S. Postal Inspection Service (USPIS); Department of Defense, Office of Inspector General, Defense Criminal Investigative Services (DOD-OIG); and Pennsylvania Office of Attorney General, Medicaid Fraud Control Unit.

As part of the kickoff event, U.S. Attorney McSwain and Assistant Attorney General Benczkowski met with senior leadership from the law enforcement partners involved to discuss the Strike Force’s work.  Assistant Attorney General Benczkowski then offered remarks to the entire Eastern District Office before departing for Washington, DC.  

“Combatting the opioid epidemic and healthcare fraud abuses are major priorities of the Department of Justice and the U.S. Attorney’s Office for the Eastern District of Pennsylvania,” said U.S. Attorney McSwain.  “Healthcare fraud schemes are driven by greed, and all American taxpayers pay the price for criminals who prey on providers and beneficiaries alike.  My Office is honored and proud to welcome the DOJ Medicare Fraud Strike Force to our District in order to attack these problems with our law enforcement partners.”

“The devastation the opioid epidemic is inflicting on communities across the country and here in the Mid-Atlantic region is staggering—and health care fraud has played a role in feeding that epidemic,” said Assistant Attorney General Benczkowski.  “It is estimated that each year tens of billions of dollars in American taxpayer money are lost to fraud, waste, abuse and improper payments.  According to the CDC, in 2016, more than 40 percent of all U.S. opioid overdose deaths involved a prescription opioid.  Our Medicare Fraud Strike Forces, which we have now expanded into Newark and Philadelphia, constitute one of our most important and effective means for containing these threats to the American people.”

On June 28, 2018, Attorney General Jeff Sessions recently noted the success of the Strike Force model while announcing the largest ever health care fraud enforcement action on Health Care Fraud Takedown Day.  The takedown involved 601 charged defendants across 58 federal districts, including 165 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving more than $2 billion in false billings.  Of those charged, 162 defendants, including 76 doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. 

Strike Force operations are part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.  Since its inception in March 2007, the prosecutors in the 10 Medicare Fraud Strike Force locations have charged over 3,700 defendants who collectively have falsely billed the Medicare program for over $14 billion.

“Bringing the time-tested, proven-effective Strike Force model along with additional prosecutors and investigators to the Philadelphia region will no doubt be highly successful in our ongoing battle against health care fraud,” said Maureen Dixon, Special Agent in Charge for HHS-OIG.  “We look forward to working closely with the U.S. Attorney for PA’s Eastern District and our fellow law enforcement partners to protect taxpayer funds supporting federal health programs and the millions who rely on those benefits.”

 “In addition to its drug law enforcement mission, the Drug Enforcement Administration regulates more than 13,000 registrants in Philadelphia and over 76,000 registrants across the Commonwealth of Pennsylvania.  A small number of these registrants engage in the unlawful diversion of prescription medications and are responsible for the illegal distribution of opioids and other dangerous narcotics,” said Jonathan Wilson, Special Agent in Charge of the DEA Philadelphia Field Division.  “Using its law enforcement and regulatory authorities, the DEA will work closely with our partner agencies in the Regional Strike Force as it investigates the unlawful diversion of controlled substance medications and health care fraud.” 

“Medicare fraud shorts the pool of funds available for truly necessary treatment and services, and costs American taxpayers money,” said Michael Harpster, Special Agent in Charge of the FBI's Philadelphia Division. “As for prescription fraud—that can cost people their lives.  Here in Philadelphia, in the heart of the opioid epidemic, it seems like the FBI is opening pill mill cases right and left.  This Regional Strike Force allows us to pool our resources, intelligence, and expertise against doctors and other medical professionals who put their own financial health ahead of their patients’ wellbeing.”

“The United States Postal Inspection Service is committed to the Health Care Fraud Task Force and combating the opioid crisis,” said Inspector-in-Charge Daniel Brubaker. “USPIS will continue to work with our partners every day to protect the public from opioid related schemes that unlawfully use the U.S. Mail.”  

“The opioid epidemic requires a strong, coordinated law enforcement response,” Attorney General Josh Shapiro said. “So far in 2018, my office has destroyed more than 26 tons of drugs. I believe that the strike force will have a direct impact on our efforts to get even more drugs and drug dealers off our streets. That is why I am proud to partner with the U.S. Attorney’s Office, the Federal Bureau of Investigation, the Department of Health and Human Services’ Office of Inspector General, the Drug Enforcement Agency and the Justice Department’s Criminal Division on this important new initiative.”