The Criminal Division, Fraud Section’s Health Care Fraud (HCF) Unit is comprised of more than 70 prosecutors whose core mission is to prosecute health care fraud-related cases involving: (1) patient harm; and/or (2) large financial loss to the public fisc. The HCF Unit has a recognized and successful Strike Force Model for effectively and efficiently prosecuting cases across the United States. Accomplishing specific and general deterrence, and protecting vulnerable patient populations, lie at the heart of its work.
The Strike Forces are modeled on a cross-agency collaborative approach, bringing together the investigative and analytical resources of the FBI, the Department of Health and Human Services Office of Inspector General (HHS-OIG), the Centers for Medicare & Medicaid Services (CMS) Center for Program Integrity (CPI), and other agencies (e.g., DEA, IRS-CI, USSS, FDIC-OIG, DOD-OIG, USPIS, DOL-OIG, DCIS), and the HCF Unit’s internal Data Analytics Team, along with the prosecutorial resources of U.S. Attorney’s Offices and state and local law enforcement partners.
Because the HCF Unit’s attorneys work full-time on HCF cases, we have become experts in prosecuting HCF-related offenses and are well-equipped to pursue significant cases involving medical professionals; corporations and executives; wide-ranging, complicated fraud schemes; and the illegal distribution and diversion of opioids and other prescription medications. The HCF Unit charges a broad range of federal statutes based upon the facts and issues involved in each case, including, but not limited to: health care fraud; wire fraud; mail fraud; bank fraud; conspiracy; money laundering offenses; false statements offenses; violations of the Anti-Kickback Statute and Title 42 offenses; tax offenses; and Title 21 offenses.
The HCF Unit currently works in the following Strike Force locations, in partnership with the U.S. Attorney’s Offices in these regions:
- Florida (Miami, Tampa, Orlando)
- Los Angeles, CA
- Texas (Houston, Dallas, McAllen/Rio Grande)
- The Gulf Coast (New Orleans, Baton Rouge, and Southern Mississippi)
- Detroit, MI
- Brooklyn, NY
- Chicago, IL
- Newark, NJ and Philadelphia, PA
- Washington, DC (National Rapid Response Strike Force)
- Kentucky, Ohio, Virginia, and West Virginia (ARPO North)
- Tennessee and Northern Alabama (ARPO South)
The HCF Unit’s cases are increasingly complex, both in the individual Strike Force locations and the National Rapid Response Strike Force. Specifically, the newly created National Rapid Response Strike Force’s mission is to investigate and prosecute fraud cases involving major health care providers that operate in multiple jurisdictions, including major regional health care providers operating in the Strike Force cities, with a focus on investigations and prosecutions of individuals and corporations. The National Rapid Response Strike Force will coordinate with the Civil Division’s Fraud Section and Consumer Protection Branch, U.S. Attorney’s Offices across the country, state Medicaid Fraud Control Units, the FBI, HHS-OIG, and other agency partners in order to identify, investigate, and prosecute significant multi-jurisdictional and corporate health care fraud cases. Examples of the types of matters under this Strike Force’s purview include a large-scale rural hospitals billing fraud matter indicted in the Middle District of Florida; the global resolution with Tenet Healthcare Corporation and related individual prosecutions; and prosecutions of those seeking to criminally exploit the COVID-19 pandemic through health care fraud and related financial fraud schemes.
In October 2018, the Criminal Division announced the formation of the Appalachian Regional Prescription Opioid (ARPO) Strike Force, a joint effort between DOJ, FBI, HHS-OIG, DEA, and state and local law enforcement to combat health care fraud and the opioid epidemic in parts of the country that have been particularly harmed by addiction. The ARPO Strike Force focuses upon prosecutions of medical professionals and others involved in the illegal prescription, diversion, and distribution of opioids, and has partnered with approximately 10 USAO Districts, divided into two main components – ARPO-North and ARPO-South. To date, the ARPO Strike Force has charged more than 73 defendants, including 64 licensed medical professionals and 48 prescribers, involving the alleged illegal distribution of 50 million controlled substance pills.
Contact us regarding Health Care Fraud
Correspondence relating to incidents of health care fraud may be sent to:
Fraud Section, Criminal Division
U.S. Department of Justice
ATTN: Chief, Health Care Fraud Unit
950 Constitution Ave., NW
Washington, DC 20530
HCF Unit Leadership
Allan Medina (link sends e-mail), Chief, Health Care Fraud Unit
Dustin Davis (link sends e-mail), Acting Principal Assistant Chief, Health Care Fraud Unit
Strike Force Based Assistant Chiefs
Dustin Davis (link sends e-mail), Assistant Chief, Gulf Coast Strike Force
Malisa Dubal (link sends e-mail), Assistant Chief, Detroit Strike Force
Adrienne Frazior (link sends e-mail), Assistant Chief, Dallas Strike Force
Aleza Remis (link sends e-mail), Assistant Chief, Houston Strike Force
Daniel Griffin (link sends e-mail), Assistant Chief, Chicago Strike Force
Niall O’Donnell (link sends e-mail), Assistant Chief, Los Angeles Strike Force
Brendan Stewart (link sends e-mail), Assistant Chief, Brooklyn Strike Force
Timothy Loper (link sends e-mail), Assistant Chief, Miami, Orlando, and Tampa Strike Force
Kilby Macfadden (link sends e-mail), Assistant Chief, ARPO North Strike Force (Ft. Mitchell-based; prosecutors focused on crimes related to the over-prescription of controlled substances and health care fraud in Southern Ohio, Eastern Kentucky, Western Virginia and Southern West Virginia)
Kate Payerle (link sends e-mail), Assistant Chief, ARPO South Strike Force (Nashville-based; prosecutors focused on crimes related to the over-prescription of controlled substances and health care fraud throughout Tennessee and Northern Alabama)
Jacob Foster (link sends e-mail), Assistant Chief, National Rapid Response Strike Force (Washington, DC-based; prosecutors focused on complex national schemes)
Tad Duree (Link sends email), Assistant Chief, Newark Strike Force