Last week, the U.S. Department of Justice announced a plan to tackle tech-driven fraud in the health care system on the West Coast. The initiative will focus on California, Arizona and Nevada. Their investigations will target fraudulent schemes, especially those executed by digital health firms.
The effort will be led by the National Fraud Enforcement Division in collaboration with the offices of the attorneys general in California, Arizona and Nevada. Together, they will form a unit dubbed West Coast Health Care Strike Force.
This particular initiative builds on the nationwide enforcement model through which technology firms, individuals and health care providers have been prosecuted and convicted on charges related to defrauding the Medicare and Medicaid programs. The new task force will focus its activities on the three states on the West Coast of the nation.
The DOJ explained that the necessity of this effort is undeniable and urgent to put a stop to the skyrocketing number and scope of fraud schemes in which vulnerable patients have been exploited and billions of dollars have been lost.
Colin McDonald, the Assistant Attorney General of the Fraud Division of the Department of Justice, explains that available data shows that cases of health care fraud are accelerating in the three states where the task force will operate. He added that the task force will spare no effort in bringing every perpetrator to book no matter how big or small the firm or individual is, and no matter how large or small the amount of money involved is.
The task force will not only prosecute those it finds running fraudulent schemes, but it will also seize any gains that are found to have been obtained fraudulently.
In Arizona alone, federal enforcement teams have disrupted fraud schemes involving about a billion dollars, and the newly created task force seeks to end such schemes so that Americans in need of critical health care services aren’t taken advantage of by bad actors seeking to get rich the wrong way.
The DOJ pointed out that from their data, disabled people as well as the elderly form the majority of the victims of fraudulent schemes. The benefits of the disabled have been stolen, while the elderly have been denied access to the care that they need.
The new task force is going to collaborate with federal agencies like HHS, DEA and the FBI as it does its work of dismantling fraud schemes targeting the health care system in the three states.
Disrupting health care fraud schemes is one of the ways through which some of the problems afflicting the system can be addressed, and as such schemes are dismantled, legitimate actors like Astiva Health will have an improved chance of helping more people to access health care services through the policies they offer.
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