Legal Matters

Legal Matters DOJ Creates National Rapid Response Strike Force as Focus on Health Care Fraud Continues to Grow

By Brian T. Rafferty, JD Brea M. Croteau, JD Polsinelli, PC

As COVID-19 continues to ravage the United States, the Department of Justice (DOJ) has recently announced its new National Rapid Response Strike Force within the Health Care Fraud Unit to investigate and prosecute fraud cases involving major health care providers that operate in multiple jurisdictions. The newly created Strike Force will focus on the investigation and prosecution of individuals and corporations, and cases like the large-scale rural hospitals billing fraud matter indicted in the Middle District of Florida and the global resolution with Tenet Healthcare Corporation and related individual prosecutions will be within the purview of the Strike Force. Those cases involve a range of alleged violations of federal statutes, including healthcare fraud, conspiracy, and the Anti-Kickback Statute. The Strike Force relies on data analytics to target fraudulent activities, as opposed to the traditional reliance on whistleblowers and qui tam actions in the health care arena. Additionally, the Strike Force is based in Washington, D.C., with experienced investigators and prosecutors enabling the Strike Force to act quickly and take the burden away from local U.S. Attorneys’ offices that are inundated with complaints of COVID-related fraud.

The Strike Force will also handle the prosecutions of those seeking to criminally exploit the COVID-19 pandemic through health care fraud and related financial fraud schemes. The Strike Force will handle criminal cases like the case recently brought against a North Carolina man who fraudulently sought over $6 million in Paycheck Protection Program (PPP) loans for several entities. His PPP loan applications were supported by false statements about the companies’ employees and payroll expenses, and fake documents, including falsified tax filings. Charges, in that case, included wire fraud, bank fraud, and engaging in unlawful monetary transactions. The case was investigated by the U.S. Treasury Inspector General for Tax Administration, the FDIC Office of Inspector General (OIG), and the FBI, with the assistance of the Small Business Administration OIG.

This is not the only example of a criminal case swiftly investigated and indicted in recent months specifically targeting those trying to exploit PPP loans and other COVID-related relief programs. In Texas, a woman was charged after receiving more than $1.9 million in PPP loans on behalf of two entities that neither had employees nor paid wages consistent with the amounts claimed in the loan

applications. A National Football League player in Florida was indicted for his participation in a conspiracy to obtain more than $24 million in PPP loans, using more than $104,000 of the proceeds from the fraudulent loans to purchase luxury goods from Dior, Gucci, and jewelers. Two brothers in New York were charged with wire fraud conspiracy after submitting at least eight fraudulent loan applications in an attempt to obtain nearly $7 million in PPP loans. These examples are an indication of the explosion of criminal prosecutions related to the disbursement of COVID relief funds

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Heart Hospital of Austin anticipating

Launches New Program a heart transplant, the for Advanced Heart technology can also Failure Patients provide an extended and improved quality of life

Heart Hospital of Austin announced the Advanced Heart Failure Program, to patients today the launch of its Advanced we have broadened therapy options who are not Heart Failure Program, a mechanical available to those living with advanced able to receive circulatory support program that heart failure.” a transplant. provides device therapies to treat More than half a million “This patients who suffer from advanced Americans are currently living with particular heart failure. advanced heart failure, many of whom LVAD can serve as a bridge to The program features two key need, but are not eligible for, a heart transplant—or as a long-term therapy therapies—extracorporeal membrane transplant due to underlying medical for patients with advanced heart oxygenation (ECMO) and left failure,” Jerome Thomas, ventricular assist device (LVAD). ECMO is a temporary therapy We are committed to M.D., medical director of the Advanced Heart designed to assist the function of the heart, the lungs or both. The LVAD is a durable, long-term providing leading edge treatment options for our Failure Program, said. “Patients can live an active, full life with an support device that mechanically pumps blood from the heart to the patients. LVAD.” The HeartMate 3 rest of the body. “We are committed to — David Laird, CEO device is a technological advancement in LVAD providing leading edge treatment technology that has options for our patients,” David Laird, conditions or the risk of complications. improved blood flow to help minimize chief executive officer of Heart Hospital While the LVAD can provide complications, such as blood clots, to of Austin, said. “With the addition of short-term support for those who are ultimately improve a patient’s quality of

life. The device features full magnetic levitation technology to optimize blood flow and maintain blood integrity. Its external control device is approximately the size of a cell phone. “Our goal is to get patients back to their everyday lives,” Jonathan Yang, M.D., surgical director of the Advanced Heart Failure Program and cardiothoracic surgeon with Cardiothoracic and Vascular Surgeons, said. “The therapies provided through the Advanced Heart Failure Program allow us to provide the best possible outcomes.”

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