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White-Collar Crime | MONDAY, FEBRUARY 10, 2014 | S3

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Early on, DOJ touted the success of its ously in connection with healthcare-related
organized crime strike forces in much the offenses. A July 2010 nationwide takedown
Visit our website to download your copy today @ www.marcumllp.com
same way as it now does the success of MFSF: appears to be the largest such takedown to
“Individuals indicted during 1968 as a result of date, with the arrest of 94 individuals across
strike force strategy numbered 71 in Brooklyn, the country for allegedly participating in
67 in Detroit, 34 in Buffalo, 12 in Chicago and schemes to submit approximately $251 mil-
5 in Philadelphia.”2
lion in Medicare claims.5
At the time of the merger of the strike Over the years that MFSF has been in exis-

forces with local U.S. Attorneys Ofices in
tence, it has utilized other hallmarks of the

In addition to takedowns of discreet cases in particular cities, in
late 2009, the Medicare Fraud Strike Force began conducting

periodic nationwide takedowns, with individuals being arrested
in a number of cities simultaneously in connection with healthcare-

related ofenses.

1990, there were 14 strike forces across the strike force approach to ighting organized

Marcum LLp, one of the largest business country, located in Brooklyn, Buffalo, Chicago, crime besides multi-agency cooperation and
valuation practices outside the “Big 4”, Cleveland, Detroit, Kansas City, Las Vegas, sprawling takedowns, including employing
Los Angeles, Miami, New Orleans and San electronic surveillance techniques, expanding
has the expertise, experience and Francisco.3
the range of crimes charged, obtaining (and
resources to provide the litigation, The success of the organized crime strike issuing press releases regarding) long prison
valuation and investigative services force approach (and continuing efforts of the sentences imposed on individuals, and even
you deserve.
U.S. Attorneys’ Ofices) was incontrovert- having “most wanted” healthcare fugitives.
ible. Waves of prosecutions relentlessly tak- Penalties of ines, forfeiture and restitution
ing down the successive hierarchies of the have been utilized to recoup public monies
ive New York City-based families of La Cosa and disincentivize fraudsters.
Nostra is one of the more memorable local
examples. While perhaps surprising at irst Discover the Diference
blush, the use of a variation on this approach The Current Look of MFSF Cases
to combat white-collar crime, including health A review of MFSF prosecutions in 2013 pro- ASSURANCE I TAX I ADVISORY
International Member of Leading Edge Alliance
care fraud, now seems a logical, even inevi- vides numerous insights into the increasingly
table, law enforcement strategy.
broad scope and continuing effectiveness
of the strike force approach to combatting
The Birth and Evolution of the MFSM
healthcare fraud:
Many Venues of Prosecution. DOJ and
MFSF was initiated in March 2007, in what its partners brought cases across the coun-
came to be Phase One, in the Southern Dis- try, including in California, Florida, Illinois,
trict of Florida (Miami). A year later, in March Louisiana, Michigan, New York, Pennsylva-
2008, Phase Two was kicked off in the Central nia, Texas and Utah. Certain federal districts
District of California (Los Angeles). As part of had a particularly high concentration of MFSF
the Health Care Fraud Prevention and Enforce- cases, including the Southern District of Flor-
ment Action Team (HEAT) initiative, a joint ida, Eastern District of Michigan and Central
effort by DOJ and HHS, in 2009, MFSF expand- District of California.
ed to Detroit, Houston, Brooklyn, Tampa and Variety of Health Care Providers Tar-

Baton Rouge. In 2011, the program expanded geted. Cases targeted executives of a health
to the total of nine cities it is today, by adding maintenance organization; the owner/opera-
Dallas and Chicago.
tor of an oncology center; the medical director
Phase One of MFSF was announced in of a hospice; the owner and program coordi-
connection with a May 2007 takedown in nator of an adult day care center; owners and
the Southern District in Florida involving the others associated with partial hospitalization
indictment of organizations and individuals programs (PHPs); owners and others associ-
in connection with allegedly conspiring to ated with home health care agencies; owners
defraud the Medicare program, making false and others associated with DMEs; owners of
claims and violating the anti-kickback stat- ambulance services; and doctors, registered
ute. Thirty-eight individuals were arrested. nurses and other medical professionals.
Collectively, approximately $142 million was Types of Crimes Charged. Charges includ-
allegedly billed in Medicare. MFSF was then ed healthcare fraud for submitting false and
described as “a multi-agency team of federal, fraudulent claims to Medicare, violations of

state and local investigators designed specii- the anti-kickback statute, and, in some recent
cally to combat Medicare fraud through the cases, money laundering.
use of real-time analysis of Medicare billing Wide-ranging penalties. Sentences includ-
data,” focusing on schemes involving infu- ed the imposition of lengthy prison terms;
sion therapy and durable medical equipment ines, restitution, and forfeiture; exclusions
(DMEs).4
from Medicare, Medicaid and other federal
MFSF became much more. There was the and state health programs; and compliance
noted expansion to nine cities. In addition to requirements.
takedowns of discreet cases in particular cit- Some speciic matters further illustrate
ies, in late 2009, MFSF began conducting peri- the scope of MFSF’s efforts and its results.
odic nationwide takedowns, with individuals 1. May 2013 Nationwide Takedown.
being arrested in a number of cities simultane-
As noted above, MFSF’s sixth »
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