Thursday, May 9, 2024

U.S. Attorney's Office Announces the Formation of Multi-Agency Health Care Fraud Task Force


Together with state and federal partners, U.S. Attorney Adair F. Boroughs announced the formation of the Palmetto Health Care Fraud Task Force (PHCF Task Force), which has been created as a dedicated task force to combat health care fraud and recover taxpayer money in the District of South Carolina through criminal and civil actions.  Other agencies that have joined the PHCF Task Force include investigators from the Department of Labor and the South Carolina Attorney General’s Medicaid Fraud Control Unit.  

In February 2023, the FBI, U.S. Attorney’s Office for the District of South Carolina, and other federal, state, and local agency partners began meeting as part of a Health Care Fraud Working Group with the goal of combatting health care fraud in the District of South Carolina.  The PHCF Task Force was created after the FBI and the U.S. Attorney’s Office saw great success from the Working Group meetings. The creation of the PHCF Task Force demonstrates an increased effort to bring to justice those who defraud the health care system, to deter future health care fraud and abuse, and to promote trust in the healthcare system. Additional resources available to the PHCF Task Force will include the FBI's Data Analytics Response Team (DART), numerous forensic accountants, and Intelligence Analysts from various agencies, which all will promote efficiency in prosecuting cases.

Health care fraud is an enormous burden on South Carolina taxpayers. In 2023, taxpayer funded healthcare programs spent approximately $23 billion in South Carolina alone. Although it is difficult to approximate the amount of money lost to waste, fraud, and abuse each year, the Government Accountability Office estimates it could be as much as 10% of money spent. The PHCF Task Force will better equip the United States to detect wrongdoers and recoup money lost to fraud in South Carolina—which costs taxpayers billions each year. 

The PHCF Task Force and agencies involved in the Health Care Fraud Working Group will meet regularly to aggressively investigate allegations of false billings, COVID-19 fraud, violations of the Anti-Kickback Statute, and other schemes that victimize patients, health care providers, private insurers, and government insurers, such as Medicare, TRICARE, and Medicaid, in the District of South Carolina.

Full Article & Source:
U.S. Attorney's Office Announces the Formation of Multi-Agency Health Care Fraud Task Force

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