The Medicare Fraud Strike Force (simply known as ‘Strike Force’), is an inter-agency team of state and federal law enforcement and health services bodies, whose key responsibility is to identify and crack down on fraud in the health care system. The strike force collects and analyses suspicious data from suspected perpetrators to identify suspicious billing and indicators of fraudulent activities of abuse.
Medicare Fraud Strike force functions as part of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative that brings together the combined resources, investigative power and collaboration of the DOJ and HHS in the enforcement of anti-fraud laws. HEAT has the following key objectives:
- To pool together resources from government resources to fight perpetrators of abuse, fraud and waste in Medicare and Medicaid.
- To ensure beneficiaries of Medicare and Medicaid are receiving quality health care by expelling from the system, medical practitioners and healthcare providers who prey on beneficiaries.
- To call attention to best practices by health professionals and care providers who are against fraud and waste.
- To recover taxpayer dollars through the efforts of The Medicare Fraud Strike Force team.
Strike force came into effect in March 2007 and currently operates in 9 cities across the United States.
The Office of Inspector General or OIG maintains a list of individuals that are excluded from participating in healthcare and some of these individuals listed have come from the Strike Force and those they have taken action against. Some of these names are also listed on individual state medicaid exclusion files, as well as with the System for Awards Management or “SAM” for short.
Since its inception, activities by the Medicare Fraud Strike Force have led to criminal actions against thousands of doctors, nurses and contractors for fraudulent crimes involving billions of dollars. Some of the crimes that perpetrators have been charged with include:
- False billings and claims,
- Billing for unnecessary care,
- Money laundering,
- Identify theft,
- Pledging to pay kickbacks,
- Receiving kickbacks,
- Operating under a fake license,
- Conspiring to commit fraud.
Through Strike Force efforts, fraudulent payments of Medicare and Medicaid have been prevented thereby saving taxpayers’ money, health care facilities involved in fraud and abuse have been shut down and arrests of persons involved in fraud have been made.
The largest take down to be carried out by Strike Force to date was in June 2016 and it resulted to charges against 301 individuals for fraudulent crimes amounting to approximately $900 million.