Who Leads Health Care Prosecutions?

Health care fraud prosecutions are led by three groups of prosecutors. 

Most investigations will be handled by a local U.S. Attorney’s office. In U.S. Attorney’s offices across the country, each district has a designated health care fraud coordinator to handle criminal and civil investigations. Although they are based out of specific geographic areas, U.S. Attorney’s offices can investigate health care fraud that occurs outside of their area if there is a connect to the area they work. Many offices have specialized prosecutors and teams who focus on health care fraud prosecutions.

At DOJ, there are also prosecutors assigned to the Criminal Division, headquartered out of Washington D.C., assigned to various DOJ’s Strike Force. As described by the DOJ, the Strike Force uses advanced data analysis techniques to “hot spots” – cities with high levels of billing fraud – combined with traditional investigative techniques. DOJ has Strike Force operations in Miami, FL; Los Angeles, CA; Detroit, MI; Houston, TX; Brooklyn, NY; the Gulf Coast; Tampa, FL; Orlando, FL; Chicago, IL; Newark, NJ and Philadelphia, PA; Dallas, TX; the Appalachian Region (Tennessee, Alabama, Ohio, Kentucky, Virginia, and West Virginia); and Washington, DC (National Rapid Response Strike Force).   

Finally, attorneys from state Attorneys General offices will frequently join federal investigations. Medicaid Fraud Control Unit (“MFCU”) prosecutors assist federal authorities and lead state investigations into similar theories of health care fraud. MFCU prosecutors can bring cases in coordination with federal authorities. Frequently, State Attorney General’s offices will assign its assistants to work as “Special Assistant United States Attorneys” to more closely coordinate investigations. MFCU units also can bring investigations and cases on their own in state court. These specialized teams of auditors and attorneys are experienced and sophisticated investigators of health care fraud.

Our attorneys are well-versed in dealing with Department of Justice (“DOJ”) prosecutors around the country, including DOJ’s Strike Force. We can help defend against large joint investigations, audits, investigations, grand jury proceedings, state Medicaid Fraud Control Unit (“MFCU”) teams, FCA investigations, Controlled Substances Act diversion investigations, misbranding investigations, and the entire range of fraud or kickback charges.

The attorneys at Griffin Durham Tanner & Clarkson are former federal prosecutors who represent clients in connection with DOJ investigations.  If you need assistance with such a matter, please contact us today.