ANNUAL REPORT OF THE FRAUD SECTION OF THE DEPARTMENT OF JUSTICE

Each year the Fraud Section of the Department of Justice compiles and publishes case data from the previous year to not only see what they have accomplished from an enforcement perspective, but to also recognize trends and determine where investigative and enforcement support is needed. The Fraud section focuses on white-collar crime enforcement and is made up of three litigating units, they are:

• The Foreign Corrupt Practices Act Unit,
• The Market Integrity and Major Frauds Unit, and
• The Health Care Fraud Unit.

In addition to these units, the Fraud Section has support units that aid the three litigating units. These support units include:

• The Strategy, Policy, & Training (SPT) Unit,
• The Special Matters Unit (SMU), and
• The Administration & Management Unit.

Between all three of these units and their support units, the Department of Justice has 161 prosecutors who investigate and prosecute these various forms of white-collar crime. In 2020, the Fraud Section as a whole charged 326 individuals with various forms of white-collar crime, which resulted in 213 convictions either by guilty plea or trial. The majority of these cases were related to health care fraud as charged by the Health Care Fraud Unit. If you are facing a health care fraud investigation, or have already been charged, then it is important that you speak to an experienced federal health care fraud attorney immediately.

WHAT IS THE HEALTH CARE FRAUD UNIT?

The Health Care Fraud Unit investigates and prosecutes federal health care fraud cases. A prime focus of the Health Care Fraud Unit is how opioids are prescribed, distributed, and diverted. The Health Care Fraud Unit’s main goals are to protect federal health care programs and to detect and deter illegal activity related to opioids. The Health Care Fraud Unit is comprised of 80 prosecutors, nearly half of the 161 prosecutors that exist across all three units of the Fraud Section. The Health Care Fraud Unit operated 15 different “Strike Forces” dealing with both health care fraud and opioid fraud across 24 federal districts. A Strike Force is a cross-agency collaboration between different investigative and law enforcement organizations to target specific illegal activity; in this case, health care fraud. 2020 saw one of the largest ever national health care fraud and prescription opioid takedowns in American history. The Health Care Fraud Unit continues to grow as big health care fraud takedowns continue.

IMPORTANT 2020 HEALTH CARE FRAUD CASE STATISTICS

In the Department of Justice Summary of 2020 Fraud Section annual report, health care fraud is at the forefront of most of the important statistics related to enforcement. Important 2020 health care fraud case statistics include:

• 167 total individuals charged with health care fraud
• 62 medical professionals were charged with health care fraud
• $3.77 billion in alleged losses due to health care fraud
• More than 29 million opioid pills were alleged to have been illegally prescribed
• Out of these 167 individuals charged, 144 of them were convicted by plea or trial
• 10 of these convictions were by a trial



Since 2019, telemedicine health care fraud has also become an important focus for the Department of Justice. The Fraud Section is responsible for charging 73 individuals with telemedicine-related health care fraud, alleging more than $3.7 billion in fraud. These numbers are expected to only continue to grow with the Department of Justice seeing some of its biggest gains in the areas of health care fraud and telemedicine-related health care fraud enforcement. If you have questions related to your specific case, then it is important that you speak to an attorney for specific advice, call us at Bajoka Law so we can help.