5 Things to Know About the Medicare Fraud Strike Force

The Medicare Fraud Strike Force is a multi-agency team of federal, state and local investigators who work together in cities across the nation to combat Medicare fraud.

Here are five things to know about the Medicare Fraud Strike Force.

1. Since its launch in 2007, the Medicare Fraud Strike Force has charged nearly 1,900 defendants who have collectively submitted more than $5 billion in fraudulent billings to the government in connection with their involvement in Medicare fraud schemes. Of the defendants charged by the strike force, 95 percent have been convicted. The strike force operates out of nine U.S. cities, including Chicago, Los Angeles and Miami. Each strike force team is led by a federal prosecutor and has investigative support from the Federal Bureau of Investigation and HHS' Office of the Inspector General.

2. Miami was the first city to receive Medicare Fraud Strike Force teams. Since 2007, Miami has grown from hosting four strike teams to 11. Miami has always been a hot spot for Medicare fraud, and it is home to nearly 1,500 medical providers who are banned from the Medicare program — more than twice as many as any other city. Florida has a second Medicare Fraud Strike Force operations site in Tampa.

3. The Medicare Fraud Strike Force operations are part of the Health Care Fraud Prevention & Enforcement Action Team. HEAT is a joint initiative between the Department of Justice and HHS that focuses on preventing and deterring fraud and enforcing anti-fraud law nationwide. From 2008 to 2011 HEAT operations led to a 75 percent increase in the number of individuals charged with criminal healthcare fraud. In 2011, HEAT coordinated the largest-ever federal healthcare fraud takedown involving $530 million in fraudulent billing.  

4. The Medicare Fraud Strike Force has conducted seven nationwide Medicare fraud sweeps. Those takedowns have resulted in 600 arrests in connection with Medicare fraud schemes involving nearly $2 billion in fraudulent billings. The largest takedown by the Medicare Fraud Strike Force happened in 2012 and resulted in 107 arrests connected to $452 million in fraudulent billings. The strike force's most recent nationwide Medicare fraud sweep led to 90 arrests in connection with more than $260 million in false claims submitted to the government. In that fraud sweep, 27 health professionals were arrested, including 16 physicians. The arrests took place in Brooklyn, N.Y., Tampa, Fla., Detroit, Houston, Los Angeles and Miami.

5. By filing charges against more individuals than it ever had before and securing more guilty pleas and jury trial convictions than in any previous year, the strike force had a record-setting year in 2013. The strike force charged 345 people, secured 234 guilty pleas and secured 46 jury trial convictions that year. The defendants who were sentenced in 2013 are facing an average of 52 months in prison. The Southern District of Illinois and the Southern District of Florida had the most Medicare fraud prosecutions per capita in 2013.

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