AG LYNCH'S REMARKS ON $712 MEDICARE FRAUD

FROM:  U.S JUSTICE DEPARTMENT
Attorney General Loretta Lynch Delivers Remarks at the Press Conference to Announce a National Medicare Fraud Takedown
Washington, DCUnited States ~ Thursday, June 18, 2015
Remarks as prepared for delivery

Good morning. Before we begin today’s announcement, I want to take a moment to address the heartbreaking and deeply tragic events at Emanuel AME Church in Charleston, South Carolina – a crime that has reached into the heart of that community.  The Department of Justice has opened a hate crime investigation into this shooting incident.  The FBI, ATF, U.S. Marshals Service, Civil Rights Division and U.S. Attorney’s Office are working closely with our state and local partners, and we stand ready to offer every resource, every means and every tool that we possess in order to locate and apprehend the perpetrator of this barbaric crime.  Acts like this one have no place in our country.  They have no place in a civilized society.  And I want to be clear: the individual who committed these unspeakable acts will be found and will face justice.

As we move forward, my thoughts and prayers – and those of our entire law enforcement community, here at the Department of Justice and around the country – are with the families and loved ones of the victims in Charleston.  Even as we struggle to comprehend this heartbreaking event, I want everyone in Charleston – and everyone who has been affected by this tragedy – to know that we will do everything in our power to help heal this community and make it whole again.

I encourage the people of Charleston and the wider area to continue circulating the photos of the alleged perpetrator and report any tip, no matter how minor, to the tip line, which can be reached at 1-800-CALL-FBI.

Today, I’m joined by Secretary [Sylvia] Burwell from the Department of Health and Human Services; Director [Jim] Comey of the FBI; Assistant Attorney General [Leslie] Caldwell of the Justice Department’s Criminal Division; Inspector General [Daniel] Levinson of the HHS Office of Inspector General; and Deputy Administrator and Director Dr. [Shantanu] Agrawal of the Centers for Medicare and Medicaid Services in announcing a major advance in the federal government’s fight against fraud in our nation’s health care system.

Over the last three days, as part of a coordinated, nationwide takedown, the Medicare Fraud Strike Force – a joint initiative of the Departments of Justice and Health and Human Services comprising federal, state and local investigators and law enforcement officials from across the country – joined seven additional U.S. Attorney’s Offices in charging or unveiling charges against 243 defendants in 17 federal districts for their alleged participation in Medicare fraud schemes involving approximately $712 million. This is the largest takedown in the Strike Force’s eight-year history.  It is the largest criminal health care fraud takedown in the history of the Department of Justice.  And it adds to an already remarkable record of enforcement.

The defendants charged include doctors, patient recruiters, home health care providers, pharmacy owners, and others.  They are accused of an array of serious crimes ranging from conspiracy to commit health care fraud to wire fraud to money laundering.  They billed for equipment that wasn’t provided, for care that wasn’t needed, and for services that weren’t rendered.  In one of the more egregious allegations of exploitation of both the Medicare system and vulnerable patients, the owners of a mental health facility in Miami billed for intensive psychotherapy sessions that resulted in tens of millions in reimbursements for the doctors based on treatment that was nothing more than moving patients to different locations.  Several of these patients suffered from illnesses like Alzheimer’s and dementia and were unable even to communicate with their supposed caregivers.

Further, nearly 50 of the defendants in this takedown are charged with fraud related to the Medicare prescription drug benefit program known as Part D, which is the fastest-growing component of the Medicare program overall.  One owner of a health care provider in the Southern District of Florida received $1.6 million from Medicare Part D for prescription drugs the provider never purchased and never dispensed.  Another defendant – a doctor in the Eastern District of Michigan – is alleged to have prescribed unnecessary narcotic pain medications to patients in exchange for the use of their identification information to generate false billings.  Patients who attempted to withdraw from the scheme were threatened with loss of access to prescription narcotics.  Having deepened these patients’ addiction, the doctors then used that addiction to keep patients bound to their scheme.  Taken in total, today’s action represents the first large-scale effort to focus on Medicare Part D fraud – and demonstrates an expanded federal focus on this important issue.

The charges we are announcing today are the culmination of a truly national effort, involving approximately 900 law enforcement personnel acting in concert to execute a set of highly complex and highly coordinated law enforcement activities stretching across the country from Florida to Alaska.  This takedown, like those before it, would not have been possible without the key partnerships forged by the Strike Force over the last eight years among federal, state, and local officials, and the cooperation spurred by the joint initiative known as the Health Care Fraud Prevention and Enforcement Action Team, or HEAT, that was launched by DOJ and HHS in 2009.  As a result of Strike Force operations since 2007, we’ve filed charges against more than 2,300 individuals, accounting for over $7 billion in Medicare losses.  This is a crucial part of the department’s health care fraud enforcement efforts, which include recovery of a total of $15.3 billion through False Claims Act cases involving fraud against federal health care programs since 2009.

Those are extraordinary figures, and they reflect our administration-wide commitment to safeguard precious public resources, to rid our health-care systems of fraud and abuse, and to sustain the integrity of programs that are essential to the public welfare.  In the days ahead, we will continue our focus on preventing wrongdoing and prosecuting those whose criminal activity drives up medical costs and jeopardizes a system that our citizens trust with their lives.  The Department of Justice is prepared – and I am personally determined – to continue working with our federal, state and local partners to bring about the vital progress that all Americans deserve.

I want to thank all of the law enforcement officials who were part of the team that made this sweeping takedown possible.  Their tireless efforts enabled us to move quickly and aggressively and their inspiring collaboration will be a model for us going forward.

At this time, I’d like to turn things over to Secretary [Sylvia] Burwell, who has been a dedicated leader and indispensable partner in this important work and who will provide additional details on today’s announcement.