1. Strike Force Operations SA Jeff Richards
HHS-OIG’s
Strike Force Operations
SA Jeff Richards

2. Strike Force Model The Strike Force is efficient:
Expedited Investigative Model
Using a Data-Driven Approach
Prosecutor Assigned to Each Team
Multi-agency > HHS-OIG, FBI, MFCU, DOJ, USAO
Non Law Enforcement Partners

3. The Strike Force Mission
To gather resources across the government to help prevent waste, fraud, and abuse in the Medicare and Medicaid programs.
To crack down on the people and organizations who abuse the system and cost Americans billions of dollars each year.
To reduce health care costs and improve quality of care by preventing fraudsters from preying on people with Medicare and Medicaid.

4. The Strike Force Mission
To highlight best practices by providers and organizations dedicated to ending waste, fraud, and abuse in Medicare and Medicaid.
To build upon the existing partnerships between HHS, DOJ and State Partners to reduce fraud and recover taxpayer dollars.

5. The True Strike Force Mission
Improve Efficiency of Prosecutions
Speed up the investigative and prosecution process.
Target particular provider types or programs that are ripe for fraud.

6. Where Did it All Begin?

7. Strike Force Origin 2007 in Miami, FL targeting DME fraud
In 2008, given the success in Miami, Strike Force is expanded to
Houston and
Los Angeles

8. Strike Force Origin
HEAT

9. HEAT
In May 2009, the Department of Health and Human Services (HHS) and Department of Justice (DOJ) created the Health Care Fraud Prevention and Enforcement Action Team (HEAT).
With its creation, the fight against Medicare fraud became a Cabinet-level priority. HEAT’s work was initially directed by HHS Secretary Kathleen Sebelius, but now is under the direction of Secretary Tom Price and US Attorney General Jeff Sessions.

10. HEAT – Strike Force Origin
2009: The Strike Force becomes a subcomponent of HEAT making it part of a Cabinet Level Initiative.
6 Cities are added
Detroit, Tampa, Brooklyn,
Dallas, Chicago and Baton Rouge

11. Strike Force Cities

12. Strike Force Accomplishments
July 2017 Takedown
412 Defendants Charged
115 Medical Professionals
$1.3 Billion in Losses
41 Federal Districts
295 Exclusion Notices
Total
Criminal Actions: 1,791
Indictments: 2,326
$2.5 Billion

13. South Louisiana Strike Force Accomplishments
Totals Since Inception
Final Criminal Actions: 95 Individuals
Awaiting sentencing: 5 individuals
Sentences up to 15 years
Unduplicated Restitution totaling approximately $150 million.
This is in addition to non Strike Force cases investigated by our office.

14. Strike Force Accomplishments
The Strike Force’s True Success:
Being able to adapt the model to different types of fraud rather than just DME
Types of Successful Cases Under Strike Force Model
HIV Drugs/Infusion, Ambulance/Medical Transport, CMHC, Home Health, Psych Visits, Physician Part B Services, Drug Diversion, Hospice, etc.

15. The Strike Force Effect

16. The Strike Force Effect
The Strike Force has had a dramatic effect on billing in several areas.
Most Notably:
DME / Power wheelchairs
CMHC

17. The Strike Force Effect

18. The Strike Force Effect CMHC Billing in Baton Rouge

19. The Strike Force Effect CMHC Billing Nationally

20. What’s Next and Emerging Trends
Strike Force
What’s Next and Emerging Trends

21. Emerging Trends Healthcare Fraud: Sophistication of Fraud Schemes
White Collar vs Organized Crime
Sophistication of Fraud Schemes
Home Health
Part D/Drug Diversion
Labs
Hospice
Continued Use of Data to Find and Fight Fraud

22. Report Fraud and Overpayments
Hotline:
1-800-HHS-TIPS ( )
Self Disclosure

23. Questions? Special Agent Jeff Richards Baton Rouge Field Office
US Department of Health and Human Services
Office of the Inspector General
Office of Investigations
Questions?