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Deputy Attorney General James Cole Speaks at the Dallas Health Care Fraud Enforcement Action Press Conference


Dallas, TX
United States

As prepared for delivery

Thank you, Sarah [Saldaña] . I’m pleased to join you, Deputy Secretary [Bill] Corr and so many other critical partners here in Dallas to announce the latest developments in the administration’s continuing fight against health-care fraud.

This morning, Dr. Jacques Roy and six other individuals were arrested on charges unsealed here in Dallas, alleging that the defendants participated in a health care fraud scheme involving nearly $375 million in fraudulent billing to Medicare and Medicaid. This represents the single largest fraud amount orchestrated by one doctor in the history of our Medicare Fraud Strike Force operations. Through the determination and skill of our Strike Force teams, we are demonstrating to those who would commit health care fraud that it won't be worth it.  If you do this, we will track you down and prosecute you.

The indictment alleges that Dr. Roy’s company, Medistat, consisted of just four doctors and approximately fifteen nurses. Yet, for the five years covered by the indictment, Dr. Roy’s company is alleged to have certified more Medicare beneficiaries for home health services, and had more beneficiaries under its care, than any other medical practice in the United States.

Over the course of those five years, Medistat is alleged to have certified more than 11,000 Medicare beneficiaries for home health services provided by more than 500 home health care agencies, or HHAs. In turn, these HHAs and Medistat are alleged to have fraudulently billed Medicare for more than $350 million, and Medicaid for more than $24 million.

The charges unsealed today would not have been possible without tremendous cooperation between the Departments of Justice and Health and Human Services, the Texas Attorney General’s Medicaid Fraud Control Unit and other agencies responsible for the Medicare program. And this announcement underscores the bold, innovative and coordinated ways in which we are working alongside authorities at every level to prevent, identify and prosecute health care fraud throughout the country.

It was exactly this type of cooperation that Attorney General Holder and Secretary Sebelius of HHS envisioned in 2009, when they formed the Health Care Fraud Prevention & Enforcement Action Team – or HEAT.

Since 2009, our joint health care fraud enforcement efforts have recovered a total of more than $10.6 billion in taxpayer funds.  This means that for every dollar Congress has provided for health care fraud enforcement over the past three years, we have recovered nearly seven dollars.

There’s no question that this is an extraordinary achievement. In fact, during Fiscal Year 2011 alone, our departments were able to recover nearly $4.1 billion in funds stolen or taken improperly from federal health care programs – an unprecedented amount.

Over the same period, the Justice Department opened more than 1,100 new criminal health care fraud investigations. We charged more than 1,400 defendants in nearly 500 cases across the country. And we secured more than 700 convictions.

At the heart of these efforts are our Medicare Fraud Strike Forces, which consist of dedicated teams run by the Justice Department’s Criminal Division and U.S. Attorneys’ Offices, in partnership with HHS, and which operate in nine locations across the country – including here in Dallas.

Thanks largely to their work, our enforcement efforts have met with continued success. And our actions – including today’s announcement – have sent a clear message: we will aggressively investigate and prosecute those who seek to defraud the American people. And taxpayers will continue to see a high rate of return on their investment in the Department of Justice.

For additional comments, I’d like to turn it over to Deputy Secretary [Bill] Corr.

Updated September 17, 2014