Health Care: DOJ Seeks Funding to Expand Strike Forces

Officials from the U.S. Department of Justice are asking Congress to significantly enhance funding for health care investigation and prosecution in the fiscal 2011 budget. Acting Deputy Attorney General Gary Grindler and acting Deputy Assistant Attorney General for the Criminal Division Greg Andres appeared before a House Appropriations subcommittee. The officials are seeking an increase of $60 million in 2011, from $30 million to $90 million, to finance strike forces to combat health care fraud.

The Department of Justice estimates that for every dollar spent on enforcement since 1996, the Medicare trust fund has realized a return of $4.00. If that ratio were to hold in effect for the proposed increase, the $60 "investment" in enforcement would realize almost a quarter of a billion dollars returned to the trust fund. Moreover, the Justice Department estimates that the country suffers annual loses of billions of dollars due to health care fraud.

There are currently health care strike forces in seven U.S. cities. The Department wants to establish as many as 13 more such strike forces. Investigators and agents assigned to the strike forces come from Department of Justice components, the Department of Health and Human Services, and state and local law enforcement. The attorneys assigned to the strike forces come from the Criminal Division of the Department of Justice and U.S. Attorneys' offices.

The first of the strike forces began in Miami in 2007. That strike force first targeted fraud in the billing for durable medical equipment. In the Miami strike force's first year, submission of durable medical equipment claims fell by $1.74 billion.

For more about the Justice Department's request to expand the strike forces, please see Main Justice, "Justice Officials Push for Expansion of Health Care Strike Forces," March 4, 2010, http://www.mainjustice.com/2010/03/04/justice-officials-push-for-expansion-of-health-care-strike-forces/.