Justice News

Attorney General Eric Holder Speaks at the Medicare Fraud Strike Force Press Conference
United States
Tuesday, May 14, 2013

Good afternoon – and thank you all for being here.  Today, I’m joined by Secretary [Kathleen] Sebelius, of the Department of Health and Human Services; Acting Assistant Attorney General [Mythili] Raman, of the Justice Department’s Criminal Division; Assistant Director [Ron] Hosko, of the FBI; Inspector General [Daniel] Levinson, of the HHS Office of Inspector General; and Dr. [Peter] Budetti, Deputy Administrator for Program Integrity of the Centers for Medicare and Medicaid Services – in announcing the latest steps forward in the federal government’s ongoing efforts to combat fraud and abuse in our health-care systems.

As part of a coordinated, nationwide takedown – the sixth that the Medicare Fraud Strike Force and its partners have conducted – this afternoon, we announce charges against 89 defendants in eight different cities for their alleged participation in fraud schemes to submit more than $220 million in false billings to Medicare.  These defendants are accused of a variety of crimes involving the fraudulent use of Medicare information obtained illegally from elderly or low-income individuals; the submission of false billings for treatments that were never provided, or were performed by unlicensed individuals; and a range of other schemes that placed the safety of innocent people at risk in order to achieve illicit financial gain.

The Departments of Justice and Health and Human Services – working alongside federal, state, and local partners – will not tolerate such activities.  We will use every appropriate tool and available resource to find, stop, and punish those who seek to take advantage of their fellow citizens.  And our commitment to protecting the American people from all forms of health-care fraud, safeguarding taxpayer resources, and ensuring the integrity of essential health-care programs – such as Medicare and Medicaid – has never been stronger.

Four years ago this month, this commitment drove us to launch a new, joint initiative known as the Health Care Fraud Prevention and Enforcement Action Team – or, HEAT.  As a result of this groundbreaking initiative, we’ve leveraged the strength of key federal, state, and local partnerships in order to take our comprehensive fight against health-care fraud to a new level.  Through the enhanced efforts of our criminal Medicare Fraud Strike Force, we’ve bolstered our ability to identify and shut down fraud schemes across the country.  And this work has yielded extraordinary results.

As a result of Strike Force operations conducted since 2007, we’ve filed charges against more than 1,500 individuals in connection with schemes involving over $5 billion in false billings.  Over the last three fiscal years, for every dollar we’ve spent fighting against health-care fraud, we’ve returned an average of nearly eight dollars to the U.S. Treasury, the Medicare Trust Fund, and others.  And our actions have helped to deter other would-be criminals from even attempting to defraud Medicare.

For example, after the Strike Force targeted group psychotherapy fraud in Detroit, we’ve seen amounts billed to Medicare for this type of treatment drop by more than 70 percent since January 2011.  Just two years after Strike Force operations in Miami identified and targeted widespread fraud in the home health industry – and launched an initiative that led to numerous arrests and lengthy prison sentences – Medicare billings for home health services in the State of Florida dropped by more than $1 billion.  And payments to providers fell by roughly $500 million.

We can all be proud of this remarkable progress.  We should be encouraged by the significant actions we announce today.  But we cannot yet be satisfied.

Unfortunately, our ability to keep building on this work, to backfill critical positions, and to strengthen Strike Force operations is being negatively impacted by sequestration – which, earlier this year, cut over $1.6 billion from the Justice Department’s budget for Fiscal Year 2013.  Unless Congress adopts a balanced deficit reduction plan and stops the reductions currently slated for 2014, I fear that our capacity to protect the American people from health-care fraud, to safeguard vital programs and precious resources, and to hold criminals accountable – will be further reduced.

Allowing these cuts would be both unwise and unacceptable.  Despite recent achievements, our work is far from over.  Significant challenges lie ahead.  And that’s why we must remain steadfast in our determination to strengthen current efforts – and keep fighting to make the positive difference our citizens need and deserve.

I’d like to thank each of the approximately 400 law enforcement officials who made arrests, executed search warrants, and otherwise participated in the investigative and enforcement actions that made today’s announcement possible.  At this time, I’d like to turn things over to another key leader of this work – my good friend, Secretary Kathleen Sebelius – who will provide additional details.

Updated August 18, 2015