Department of Justice Seal

FOR IMMEDIATE RELEASE

AG

MONDAY, APRIL 26, 1999

(202) 514-2007

WWW.USDOJ.GOV

TDD (202) 514-1888


Contacts:

Chris Watney
Department of Justice
(202) 514-2007

Judy Holtz
HHS, Office of the Inspector General
(202)619-0260

James Polley
National District Attorneys Association
(703) 519-1651

Maureen Thompson
National Association of Attorneys General
(202) 326-6006


TOP HEALTH CARE FRAUD OFFICIALS MEET AS NATIONAL TASK FORCE

New Task force focuses on nursing home fraud and exclusion from Medicare Program

WASHINGTON, D.C. - Top officials from federal, state and local law enforcement agencies responsible for fighting health care fraud and abuse met for the first time today as the National Health Care Fraud and Abuse Task Force to discuss a variety of policy issues including the development of steps to fight nursing home fraud and abuse and exclude dishonest providers from participation in Medicare, Medicaid and other government-funded health care programs.

National Task Force officials who met today at the Justice Department included: Deputy Attorney General Eric H. Holder, Jr., who chairs the Task Force; June Gibbs Brown, Inspector General, Department of Health and Human Services; Lynn A. Hunt, Chief of the Financial Crimes Section, Federal Bureau of Investigation; state Attorneys General Betty Montgomery (Ohio) and Drew Edmondson (Oklahoma), representing the National Association of Attorneys General (NAAG); John Justice, Solicitor (Chester, S.C.), representing the National District Attorneys Association; and John Guthrie, Director of the Ohio Medicaid Fraud Control Unit and President of the National Association of Medicaid Fraud Control Units.

"Fraud schemes in the United States health care system cost taxpayers billions of dollars every year," said Holder. "This task force will foster communication and coordination at the highest levels where policy development and implementation can make a significant difference."

One of the issues addressed at today's kick-off meeting of the National Task Force was increased coordination and information sharing to boost federal, state and local nursing home prosecutions.

"During our meeting today, all task force members expressed their strong commitment to working together to protect our vulnerable nursing home population and in stepping up law enforcement efforts against those who harm them," said Holder.

Task Force members are organizing four regional conferences this year to focus on improving quality of care in nursing homes. The conferences will be held in Los Angeles in July, Philadelphia in September, Des Moines in October and South Carolina in November. In addition, task force members are working together to form or expand multi-agency working groups in every state where federal, state, and local law enforcement personnel and regulators will meet with other experts to discuss and develop the most effective ways to protect senior citizens in nursing homes.

The Task Force also will develop a database of information, including projects, studies, reviews and initiatives relating to nursing home quality of care and enforcement which will be available to members.

Another issue addressed today by the National Task Force was how to increase the number of dishonest providers who are excluded from Medicare, Medicaid and other federal health programs. While federal laws authorize such exclusions, the process is dependent on the timely reporting of conviction information to the HHS Office of Inspector General. In months to

come, the National Task Force will explore ways to increase reporting by federal, state and local agencies. The group also will look to state licensing agencies for assistance in the suspension or revocation of the licenses of dishonest providers.

"Federal, state and local prosecutions are critical to protecting the integrity of our programs by prosecuting dishonest providers. State Licensing Boards play a vital role in protecting quality of care providing to our beneficiaries," said June Gibbs Brown, HHS Inspector General. "Exclusion from these programs is a second equally powerful tool in our fight against waste, fraud and abuse. We will be expanding our efforts to educate prosecutors and state licensing authorities about this critical tool. We want all unscrupulous and abuse providers out of our programs."

The National Task Force will focus on a full range of additional issues relating to health care fraud, including:

  • Medical records privacy and the need to ensure the privacy of sensitive medical records with the need to protect the public through the investigation and prosecution of crimes;
  • strategies to bolster the investigation and prosecution of criminal and civil health care fraud and policies and procedures for the coordination of enforcement efforts that impact multiple jurisdictions;
  • the use of information technology to detect and combat fraud, including examining and identifying electronic fraud detection measures, approaches, and analytical tools as well as potential mutual areas of benefit from promoting greater uses of such technology across government-sponsored health care programs; and
  • training programs for prosecutors, investigators and other law enforcement officials, with an emphasis on the development of "best practices" and the use of inter-agency efforts to combat health care fraud.

The National Task Force will meet at least twice annually to develop directives and policy, and senior staff from member entities will meet on a quarterly basis to discuss issues and ensure proper follow-up and implementation.

"Those who commit health care fraud need to be put out of business - and thanks to the initiatives we're announcing today, they will be," said Ohio Attorney General Betty D. Montgomery, Vice Chair of the Consumer Protection Committee of NAAG. "This is just the beginning of state, federal and local health care law enforcement officials joining forces to put a halt to this type of crime. Together, we'll share law enforcement information, bar known offenders from the health care industry, crack down on nursing home abuses, and protect medical records privacy."

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