January 25, 2022

News

News Network

Gulf Coast Health Care Fraud Strike Force Expanded to Include Eastern District of Texas

15 min read
<div>The Department of Justice announced the expansion of the Criminal Division, Fraud Section’s existing Gulf Coast Health Care Fraud Strike Force to include the Eastern District of Texas.</div>

The Strike Force will Focus on Health Care Fraud and Illegal Opioid Prescriptions and Distribution

The Department of Justice announced the expansion of the Criminal Division, Fraud Section’s existing Gulf Coast Health Care Fraud Strike Force to include the Eastern District of Texas. 

The Strike Force is a joint law enforcement effort that brings together the resources and expertise of the Health Care Fraud (HCF) Unit in the Criminal Division’s Fraud Section, the U.S. Attorney’s Offices for the Eastern District of Texas, the Middle District of Louisiana, the Eastern District of Louisiana, and the Southern District of Mississippi, as well as law enforcement partners at the FBI, U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG), U.S. Drug Enforcement Administration (DEA), and other federal and state partners.

“Each year, healthcare fraud costs the American taxpayers tens of billions of dollars,” said Acting Assistant Attorney General Brian C. Rabbitt of the Justice Department’s Criminal Division.  “The Criminal Division’s Health Care Fraud Strike Forces are a critical tool in the Department of Justice’s efforts to identify, investigate, and prosecute those who defraud our healthcare system.  We are eager to announce this new partnership with the Eastern District of Texas, which will enhance and expand our efforts to prosecute healthcare fraud and protect American taxpayers.”

“The fight against health care fraud is a top priority for the U.S. Attorney’s Office for the Eastern District of Texas,” said U.S. Attorney Stephen J. Cox of the Eastern District of Texas. “We are honored to join the department’s Gulf Coast Strike Force and look forward to working together with them and with our law enforcement partners to protect the people of the Eastern District from fraud and abuse and to bring wrongdoers to justice.”

“The FBI is the primary agency for exposing and investigating health care fraud and we are pleased that the expansion of the Gulf Coast Health Care Fraud Strike Force into the Tyler area will allow us to vigorously pursue the most egregious offenders through coordinated law enforcement operations with our investigative partners,” said Special Agent in Charge Matthew J. DeSarno of the FBI’s Dallas Field Office.

“Health care fraud is a multi-billion dollar criminal enterprise,” said Special Agent in Charge Perrye K. Turner of the FBI’s Houston Field Office.  “The FBI Houston Division sees significant success when we partner with multiple agencies to combat health care fraud in our communities.  We look forward to expanding these efforts through the Gulf Coast Health Care Fraud Strike Force and continuing to strengthen our partnerships in the Eastern District of Texas.”

“The diversion of prescription pharmaceuticals is a public health epidemic impacting many communities throughout the country.  The communities in the Eastern District of Texas are no different,” said Special Agent in Charge Steven S. Whipple of the DEA Houston Division. “We welcome the specialized prosecutorial resources that the Gulf Coast Strike Force brings to the Eastern District of Texas.” 

“The OIG’s unwavering commitment in working with our law enforcement partners throughout the country on Strike Force Teams has resulted in more than a thousand arrests and recovered millions of taxpayer dollars,” said Special Agent in Charge Miranda Bennett of HHS-OIG.  “OIG looks forward to continuing these important accomplishments through our already dynamic partnerships in the Eastern District of Texas.”

The HCF Unit operates 15 Strike Forces across the United States, in 24 federal districts, including Miami, Tampa, and Orlando, Florida; Los Angeles, California; Detroit, Michigan; Houston, Texas; Brooklyn, New York; the Gulf Coast; Tampa, Florida; Chicago, Illinois; and Dallas, Texas, along with the National Rapid Response Strike Force located in Washington, D.C.  The Strike Forces represent a partnership between the Criminal Division, U.S. Attorney’s Offices, the FBI and HHS-OIG, and other federal and local agency partners.

The Strike Force will be made up of prosecutors and data analysts with the HCF Unit, prosecutors with the U.S. Attorney’s Offices for the Eastern District of Texas, and special agents with the FBI, HHS-OIG and DEA.  In addition, the Gulf Coast Strike Force will work closely with other various federal law enforcement agencies.  The Strike Force will focus its efforts on aggressively investigating and prosecuting cases involving fraud, waste, and abuse within our federal health care programs, and cases involving illegal prescribing and distribution of opioids and other dangerous narcotics.

In September, Acting Assistant Attorney General Rabbitt noted the success of the Strike Force model while announcing a historic nationwide enforcement action involving 345 charged defendants across 51 federal districts, including more than 100 doctors, nurses and other licensed medical professionals.  Five of the defendants were indicted in the Eastern District of Texas.  Altogether, these defendants have been charged with submitting more than $6 billion in false and fraudulent claims to federal health care programs and private insurers, including more than $4.5 billion connected to telemedicine, more than $845 million connected to substance abuse treatment facilities, or “sober homes,” and more than $806 million connected to other health care fraud and illegal opioid distribution schemes across the country.  More information can be obtained at: https://www.justice.gov/usao-edtx/pr/largest-health-care-fraud-and-opioid-enforcement-action-department-justice-history.

Among those charged in the Eastern District were Steven Churchill, 34, of Boca Raton, Florida, Samson Solomon, 22, of West Palm Beach, Florida, David Warren, 49, of Boca Raton, Florida, and Daniel Stadtman, 66, of Allen, Texas.  The defendants are alleged to have conspired to pay and receive kickbacks in exchange for physicians’ orders from purported telemedicine companies.  The physicians’ orders were used to submit claims for payment to federal health care programs.  The conspirators obtained patient information, including protected health information and personally identifiable information, used the information to create fictitious physicians’ orders, and sold the physicians’ order to each other and to other durable medical equipment providers.  Within approximately eight months, the defendants collectively obtained more the $2.9 million in proceeds from the scheme.

In another Eastern District case, Clifford Russell Harris, a 38-year-old registered nurse, pleaded guilty to recklessly endangering Texarkana, Texas, patients by stealing fentanyl.  Harris broke into the secure drug storage at Healthcare Express in Texarkana, Texas, and tampered with vials of fentanyl stored there.  He extracted the fentanyl from the vials and refilled the vials with another liquid.  Harris then returned the vials to the drug stock where they were available for administration to patients.  Harris admitted that he had acted with reckless disregard of the danger to patients and that his actions manifested an extreme indifference to that risk. 

The Strike Force operations are part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.  Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,200 defendants who have collectively billed the Medicare program for approximately $19 billion.

The year 2020 marks the 150th anniversary of the Department of Justice.  Learn more about the history of our agency at www.Justice.gov/Celebrating150Years.

News Network

  • Former Mexican governor sent to US prison for money laundering
    In Justice News
    A former Coahuila, [Read More…]
  • Department Press Briefing – July 16, 2021
    In Crime Control and Security News
    Jalina Porter, Principal [Read More…]
  • Judicial Security Legislation Stalls, Awaits Congressional Action in 2021
    In U.S Courts
    On Wednesday afternoon, the United States Senate considered but failed to act on the Daniel Anderl Judicial Security and Privacy Act of 2020, legislation that would enhance the security protections for federal judges nationwide.
    [Read More…]
  • Deputy Secretary Sherman’s Participation in an Extraordinary Session of the Strategic Stability Dialogue with Russian Deputy Foreign Minister Sergey Ryabkov
    In Crime Control and Security News
    Office of the [Read More…]
  • Military Operations: DOD Needs to Address Contract Oversight and Quality Assurance Issues for Contracts Used to Support Contingency Operations
    In U.S GAO News
    The Department of Defense (DOD) uses contractors to meet many of its logistical and operational support needs. With the global war on terrorism, there has been a significant increase in deployment of contractor personnel to areas such as Iraq and Afghanistan. In its fiscal year 2007 report, the House Appropriations Committee directed GAO to examine the link between the growth in DOD's operation and maintenance costs and DOD's increased reliance on service contracts. GAO determined (1) the extent to which costs for selected contracts increased and the factors causing the increases, (2) the extent to which DOD provided oversight for selected contracts, and (3) the reasons for DOD's use of contractors to support contingency operations. To address these objectives, GAO reviewed a nonprobability sample of seven DOD contracts for services that provide vital support to contingency operations in Iraq and Afghanistan. GAO reviewed contract requirements, funding documents and DOD guidance for these contracts and interviewed DOD and contractor personnel.Costs for six of the seven contracts GAO reviewed increased from an initial estimate of $783 million to about $3.8 billion, and one consistent and primary factor driving the growth was increased requirements associated with continued military operations in Iraq and Afghanistan. For example, the Army awarded a $218.2 million task order for equipment maintenance and supply services in Kuwait in October 2004. Since then, approximately $154 million of additional work was added to this task order for vehicle refurbishment, tire assembly and repair, and resetting of prepositioned equipment. Other factors that increased individual contract costs include the use of short-term contract extensions and the government's inability to provide contractually required equipment and services. For example, in three of the contracts GAO reviewed, short-term contract extensions (3 to 6 months) increased costs because the contractor felt it was too risky to obtain long-term leases for vehicles and housing. The actual cost of one contract we reviewed did not exceed the estimated cost for reasons such as lower than projected labor rates. GAO has frequently reported that inadequate staffing contributed to contract management challenges. For some contracts GAO reviewed, DOD's oversight was inadequate because it had a shortage of qualified personnel and it did not maintain some contract files in accordance with applicable guidance. For five contracts, DOD had inadequate management and oversight personnel. In one case, the office responsible for overseeing two contracts was short 6 of 18 key positions, all of which needed specialized training and certifications. In addition, for two other contracts, proper accounting of government owned equipment was not performed because the property administrator position was vacant. Second, DOD did not always follow guidance for maintaining contract files or its quality assurance principles. For four contracts, complete contract files documenting administration and oversight actions taken were not kept and incoming personnel were unable to determine how contract management and oversight had been performed and if the contractor had performed satisfactorily prior to their arrival. In addition, oversight was not always performed by qualified personnel. For example, quality assurance officials for the linguist contract were unable to speak the language so they could not judge the quality of the contractor's work. Without adequate levels of qualified oversight personnel, proper maintenance of contract files, and consistent implementation of quality assurance principles, DOD may not be able to determine whether contractors are meeting their contract requirements, which raises the potential for waste. DOD used contractors to support contingency operations for several reasons, including the need to compensate for a decrease in force size and a lack of capability within the military services. For example, an Army contract for linguist services had a requirement for more than 11,000 linguists because DOD did not have the needed linguists. According to Army officials, the Army phased out many interpreter positions years ago and did not anticipate a large need for Arabic speakers.
    [Read More…]
  • Former Police Detective and FBI Task Force Officer Convicted of Bribery and Other Offenses
    In Crime News
    A federal jury convicted a veteran detective for the Carlisle, Pennsylvania Police Department, who was also a task force officer with the FBI and a member of the Cumberland County Drug Task Force, today of bribery, drug distribution and making false statements.
    [Read More…]
  • Justice Department Files Complaint to Stop Distribution of Unapproved, Misbranded, and Adulterated “Poly-MVA” Products
    In Crime News
    The United States filed a civil complaint to stop a California company from distributing unapproved and misbranded drugs and adulterated animal drugs, the Department of Justice announced today.
    [Read More…]
  • Nuclear Waste Cleanup: DOE Needs to Better Coordinate and Prioritize Its Research and Development Efforts
    In U.S GAO News
    What GAO Found The Department of Energy's (DOE) Office of Environmental Management (EM) identifies cleanup-related research and development (R&D) needs across the EM complex—EM headquarters and sites and DOE's national laboratories—in various ways. For example, DOE officials and contractors at EM sites work closely with national laboratories to identify project-specific R&D needs, including those encountered during the course of cleanup activities, such as managing vapors in nuclear waste storage areas. EM headquarters may identify complex-wide needs (e.g., ways to improve worker safety, such as using robotics, see figure) or work with other DOE offices, including the Office of Nuclear Energy, to identify R&D needs that span DOE missions, such as spent nuclear fuel storage. Robotic Technologies Potentially Applicable to Department of Energy Nuclear Cleanup Efforts EM uses both formal and informal mechanisms to coordinate R&D across the EM complex, including the national laboratory network and working groups. EM's coordination of R&D efforts fully aligns with four of GAO's seven leading practices for collaboration, such as clarifying roles and responsibilities and including relevant participants. However, EM does not fully follow other leading practices, which affects its ability to evaluate the effectiveness of R&D efforts. For example, EM officials told GAO that it does not have a formal system to collect information on R&D activities across the complex, which would enable it to monitor and evaluate the activities' outcomes. Collecting such information could help EM determine whether to encourage or discourage investments in certain areas. EM also does not take a comprehensive approach to prioritizing R&D. Individual EM sites and national laboratories have their own decision-making processes for prioritizing R&D, but these may not address long-term or complex-wide needs. GAO has found that risk-informed decision-making can help agencies weigh numerous factors and consider tradeoffs, and that doing so would help EM set cleanup priorities within and across its sites. By developing a comprehensive approach to prioritizing R&D that follows a risk-informed decision-making framework, EM would be better positioned to provide sites with guidance for R&D spending beyond their immediate operational needs and direct its limited R&D resources to its highest priorities. Why GAO Did This Study R&D has played an essential role in EM's efforts to clean up massive amounts of contamination from decades of nuclear weapons production and energy research. Such R&D has led to safer, more efficient, and more effective cleanup approaches. Prior studies have found that investments in R&D could reduce the future costs of EM's cleanup efforts, which have increased by nearly $250 billion in the last 10 years. However, funding designated for nuclear cleanup R&D has declined since 2000. GAO was asked to review EM's R&D efforts. This report examines (1) how EM identifies cleanup-related R&D needs, (2) how and the extent to which EM coordinates R&D across the EM complex, and (3) the extent to which EM prioritizes cleanup-related R&D efforts. GAO reviewed DOE and EM documents and interviewed EM site and headquarters officials and national laboratory representatives. In addition, GAO compared EM's coordination of R&D to leading practices for collaboration and compared EM's efforts to prioritize R&D with GAO's risk-informed decision-making framework.
    [Read More…]
  • Bangladesh Travel Advisory
    In Travel
    Reconsider travel to [Read More…]
  • Texan sentenced in CARES Act unemployment fraud scheme
    In Justice News
    A 29-year-old Corpus [Read More…]
  • Statement by Attorney General William P. Barr on Senate Resolution
    In Crime News
    Online child sexual exploitation is a global crime that demands a continued global response. 
    [Read More…]
  • Secretary Blinken’s Call with EU High Representative Borrell
    In Crime Control and Security News
    Office of the [Read More…]
  • Assistant Attorney General Makan Delrahim Announces Re-Organization of the Antitrust Division’s Civil Enforcement Program
    In Crime News
    The Department of Justice’s Antitrust Division announced today that it is creating the Office of Decree Enforcement and Compliance and a Civil Conduct Task Force.  Additionally, it will redistribute matters among its six civil sections in order to build expertise based on current trends in the economy.
    [Read More…]
  • North Carolina Tax Preparer Charged with Conspiracy to Defraud the IRS and Aggravated Identity Theft
    In Crime News
    A federal grand jury in Durham, North Carolina, returned an indictment yesterday charging a tax preparer with conspiring to defraud the United States, preparing false tax returns, filing a false personal tax return, and committing aggravated identity theft, announced Acting Deputy Assistant Attorney General Stuart M. Goldberg of the Justice Department’s Tax Division and U.S. Attorney Matthew G.T. Martin for the Middle District of North Carolina.
    [Read More…]
  • Nepali Constitution Day
    In Crime Control and Security News
    Antony J. Blinken, [Read More…]
  • Attorney General Garland Participates in Quintet Meeting of Attorneys General
    In Crime News
    The annual meeting of the five Attorneys General from New Zealand, Australia, Canada, the United Kingdom and the United States was held this year by video conference on Dec. 2 and 3, 2021.
    [Read More…]
  • Indiana Man Charged with Hate Crime for Making Racially-Motivated Threats Towards Black Neighbor, and With Unlawful Possession of Firearms
    In Crime News
    The Justice Department announced today that Shepherd Hoehn, 50, has been charged by criminal complaint in federal district court with one count of violating 42 U.S.C. § 3631 for making threats to intimidate and interfere with his African-American neighbor because of the neighbor’s race and because of his use and enjoyment of his property, as well as two counts of violating 18 U.S.C. § 922(g) for unlawfully possessing firearms.
    [Read More…]
  • Puerto Rico Electricity: FEMA and HUD Have Not Approved Long-Term Projects and Need to Implement Recommendations to Address Uncertainties and Enhance Resilience
    In U.S GAO News
    As of October 2020, 3 years since the hurricanes destroyed much of Puerto Rico's electricity grid, neither the Federal Emergency Management Agency (FEMA) nor the Department of Housing and Urban Development (HUD) had approved long-term grid recovery projects in Puerto Rico. In 2019, GAO made four recommendations to FEMA and HUD to address identified challenges in rebuilding the electricity grid in Puerto Rico. As of October 2020, FEMA had fully implemented one recommendation and partially implemented two others, while HUD had not implemented its recommendation. Specifically, FEMA established an interagency agreement with the Department of Energy (DOE) to clarify how the agencies would consult on recovery efforts. FEMA had taken actions to partially implement recommendations on improving coordination among federal and local agencies and providing information on industry standards. However, further steps are needed, including finalizing guidance on FEMA's process for approving funding for projects. Regarding HUD, it has not addressed GAO's recommendation to establish time frames and requirements for available funding. Damaged Power Lines in Puerto Rico in November 2017 after Hurricane Maria Until HUD and FEMA implement GAO's recommendations, uncertainty will linger about how and when federal funding for long-term grid recovery will proceed. In particular, it is uncertain how available funding sources will support measures to enhance grid resilience to hurricanes, such as smart grid technology. FEMA officials told GAO that additional funding sources could be used for resilience measures but that this would not be determined until specific projects are submitted to FEMA for approval. Moreover, although FEMA finalized a $10 billion cost estimate for grid repairs in September 2020, several steps remain before FEMA approves funding for projects—a process officials said they were drafting. HUD funding could supplement FEMA funding but, as discussed above, HUD has yet to establish conditions for using these funds and has not established time frames and a plan for issuing this information. According to HUD officials, they plan to publish requirements in the first quarter of fiscal year 2021, but this depends on other factors, such as input from other federal agencies. Further delays in publishing the conditions could contribute to delays in Puerto Rico's ability to initiate grid recovery projects. In 2017, Hurricanes Irma and Maria damaged Puerto Rico's electricity grid, causing the longest blackout in U.S. history. It took roughly 11 months after the hurricanes for power to be restored to all of the customers with structures deemed safe for power restoration. Since electricity service has been restored, local entities have undertaken the longer-term task of more fully repairing and rebuilding the grid. GAO reported in 2019 on challenges hindering progress in rebuilding the grid and recommended that FEMA and HUD take actions to address these challenges. This report examines the status of efforts to support long-term grid recovery in Puerto Rico, including actions taken by FEMA and HUD to implement GAO's 2019 recommendations. For this report, GAO assessed agency actions; reviewed relevant reports, regulations, policies, and documents; and interviewed federal and local officials. GAO previously made three recommendations to FEMA and one to HUD to provide needed information and improve coordination to support grid recovery. Both agencies disagreed with GAO's characterization of their progress made addressing these prior recommendations. GAO continues to believe additional actions are needed to fully implement these recommendations. For more information, contact Frank Rusco at (202) 512-3841 or ruscof@gao.gov.
    [Read More…]
  • United States Proposes Modification to EPA Consent Decree to Reduce Sewer System Overflows for the Hampton Roads Sanitation District
    In Crime News
    The United States lodged with the U.S. District Court of Eastern Virginia today a proposed modification of the Environmental Protection Agency’s (EPA) 2010 consent decree with the Hampton Roads Sanitation District (HRSD) to require implementation of a comprehensive set of improvements to the sewer system to resolve longstanding problems with sanitary sewer overflows (SSOs).
    [Read More…]
  • Information Technology: Biannual Scorecards Have Evolved and Served as Effective Oversight Tools
    In U.S GAO News
    What GAO Found The Subcommittee's biannual scorecards initially focused on agencies' progress in implementing statutory provisions contained in the Federal Information Technology Acquisition Reform Act (FITARA) on topics such as incremental development and data center consolidation. The scorecard evolved over time to include additional IT-related components such as Chief Information Officer (CIO) direct reporting, software licensing, and cybersecurity (see figure). Biannual Scorecards Release Timeline with Associated Components The biannual scorecards have served as effective tools for monitoring federal agencies' efforts in implementing statutory requirements and addressing other important IT issues. For example, the Subcommittee-assigned grades of agency performance have shown steady improvement. Specifically, from November 2015 through December 2021, agencies receiving C or higher grades increased from 29 to 100 percent (all agencies). For the most recent scorecard, 50 percent of agencies received an A or B. This escalation in grades reflects the notable improvements in components of the scorecard. For example: Portfolio review savings. The amount of cost savings and avoidances reported from annually reviewing IT portfolios increased from $3.4 billion to $23.5 billion. CIO direct reporting. The number of agency CIOs that report directly to the Secretary or Deputy increased from 12 to 16 of the 24 agencies. Software licensing. The number of agencies with comprehensive, regularly updated software licensing inventories went from 3 to all 24, resulting in the removal of this component from the scorecard. Going forward, it will be important for Congress to continue adapting oversight tools, such as the biannual scorecards, to meet the advancing federal IT landscape. Why GAO Did This Study The federal government annually spends more than $100 billion on IT and cyber-related investments; however, many of these investments have failed or performed poorly and have often suffered from ineffective management. To improve the management of IT, Congress and the President enacted FITARA in December 2014. The law better enables Congress to monitor covered agencies' progress in managing IT and hold them accountable. FITARA applies to the 24 agencies subject to the Chief Financial Officers Act of 1990, although not all FITARA provisions apply to the Department of Defense. In November 2015, this Subcommittee began issuing biannual scorecards as an oversight tool to monitor agencies' progress toward implementing FITARA and subsequently, other IT-related issues. The scorecards rely on publicly available data to track and assign federal agencies letter grades (i.e., A, B, C, D, or F). As of January 2022, thirteen scorecards had been released. GAO was asked to testify on the evolution and effectiveness of the biannual scorecards. For this testimony, GAO relied primarily on previously issued products. For more information, contact Carol C. Harris at (202) 512-4456 or harriscc@gao.gov.
    [Read More…]

Crime

Network News © 2005 Area.Control.Network™ All rights reserved.