The acting U.S. attorney in Chicago has announced the creation of a new unit dedicated to the prosecution of criminal health care fraud violations the latest indication that the U.S. Department of Justice considers the area a key priority.
The five-prosecutor team will operate within the office's criminal division and pursue all forms of health care fraud, from fraudulent billing to diversion of controlled substances, Joel Levin, acting U.S. attorney for the Northern District of Illinois, said in a statement.
The announcement comes days after the Justice Department's annual health care fraud takedown. Prosecutors charged 412 defendants nationwide, including 115 doctors, nurses and other licensed medical professionals, for allegedly participating in health care fraud schemes amounting to $1.3 billion. Of those charged, more than 120 defendants, including doctors, were charged for their roles in prescribing and distributing opioid painkillers and other dangerous narcotics. Fifteen individuals in total were charged in the U.S. District Court for the Northern District of Illinois, according to the DOJ.
The development in Chicago, as well as the takedown, represent what health care lawyers have identified as a growing trend in health care fraud enforcement: the criminalization of charges that traditionally were civilly prosecuted.
"There's been an acceleration in the amount of resources that the DOJ is going to put into the investigation, on the criminal level, of health care fraud," said Patrick Cotter, a former federal prosecutor and head of the government interaction and white-collar practice group at Greensfelder, Hemker & Gale in Chicago, citing the recent announcement of the new Chicago unit.
"What I'm encountering today, when [my client and I] find ourselves in conference rooms, we're talking to not only a civil assistant U.S. attorney but also a criminal assistant U.S. attorney," he said. "The old rules about how mistakes will be treated may no longer be true."
The new health care fraud unit is expected to expand on the Northern District of Illinois office's "long history of prosecuting significant health care fraud cases," Levin said. Some of those past cases include:
A chiropractor, along with his father and brother, sentenced to prison in connection with a phony billing scheme that bilked insurance carriers out of more than $10.8 million.
Ten criminal convictions stemming from a conspiracy among several Chicago hospital executives to pay kickbacks and bribes to physicians for patient referrals for services that would be reimbursed by Medicare and Medicaid. Among the convictions at Sacred Heart Hospital, which closed in 2013, were its owner and CEO, chief financial officer and chief operating officers.