December 18, 2019

New figures reveal feds’ biggest focus in health care fraud

The federal government has made it known they are laser focused on Medicare and Medicaid fraud. That means even an innocent misstep on the part of an individual may draw the attention of authorities, including the Medicare Fraud Strike Force.

The most recent 2019 report from the Department of Health and Human Services Office of Inspector General (OIG) reveals some surprising figures about the breadth of this ongoing effort.

According to the OIG, investigations involving Medicare and Medicaid represent their “largest body of work.” Over a six-month period starting April 1, 2019, 353 individuals or entities faced criminal action over Medicare or Medicaid fraud allegations, while 357 were forced to respond to civil actions reported by the OIG. These figures show the intense level of scrutiny currently being employed by the federal government.

The report specifically highlights a Florida case, in which one resident was sentenced to 20 years in prison after being convicted in the largest fraud scheme ever charged by federal authorities. Overall, the most common type of fraud alleged by investigators was false claims for reimbursement.

What individuals should keep in mind

These types of investigations are serious, and carry the weight of the federal government behind them. It can be quite daunting to learn you are under scrutiny or facing criminal charges, particularly if you’re not sure why. Crucial to ensuring this development impacts your life as little as possible is putting up a robust defense.

One of the most effective ways to help yourself is to keep detailed records. If you can demonstrate, through receipts, that you did not do what you’re being accused of, that can be a significant boon to your case.

However, federal charges are sometimes quite broad, and prosecutors can wield them how they so choose. This means, as soon as you learn you may be involved in a federal investigation, it is smart to take certain steps to protect yourself, your loved ones and your life. With a clear defense and thorough plan for handling the allegations, you can be prepared for much of what might come.

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