Back in February, the Department of Justice’s Criminal Division Fraud Section released its annual review. Of the Fraud Section’s three litigation divisions, Health Care Fraud, Market Integrity and Major Frauds and Foreign Corrupt Practices Act, Health Care Fraud is the largest with nearly twice as many trial attorneys and the most active unit.

In addition to the usual statistics about the number of attorneys, defendants charged and number of trials, the report also announced a change in how their trial attorneys are assigned in the field. Previously, trial attorneys were assigned to strike force cities in 24 judicial districts. Under the new deployment, the cities are grouped into regions allowing a broader approach and sharing of resources in wider areas.

The report noted that enforcement actions were prioritized in areas involving pharmaceuticals, telemedicine, laboratory testing and durable medical equipment. There is also an emphasis on vulnerable populations, such as the elderly or addicted patients.

DOF continues to utilize its analytics unit to identify suspicious healthcare billing patterns and geographic hot spots for fraudulent activities. The analytics unit, formed in 2018, provides proactive referrals based on the data analysis.

The takeaway from the report was that DOJ continues to prioritize healthcare fraud as a major program initiative. Certainly the number of cases involving healthcare fraud prosecuted by the Fraud Division and the U.S. Attorneys’ Offices around the country bear that out. Just yesterday, DOJ announced charges against 193 individuals and over $2.75 billion in false claims as part of its 2024 National Health Care Fraud Enforcement Action.

These cases involve allegations of improper distribution of opioids, false and fraudulent claims for not medically necessary prescriptions for drugs and durable medical equipment, unnecessary lab work, and kickbacks and other forms of illegal payments to induce such prescriptions.

Stahl Gasiorowski Criminal Defense Attorneys are very experienced in defending individuals charged with various healthcare fraud offenses. We have aggressively defended physicians, pharmacists, suppliers and marketers. To contact us call 908.301.9001 for the NJ office and 212.755.3300 for the NYC office, or email Mr. Stahl at rgs@sgdefenselaw.com or Laura K. Gasiorowski at lkg@sgdefenselaw.com.