Health-Care Fraud Probes Are ‘Covert,’ Speedier Due to Virus

Federal investigators are leaning heavily on nontraditional methods to expedite criminal probes of health-care fraud tied to the coronavirus pandemic, a top Justice Department official said.

Joseph Beemsterboer, senior deputy chief of the DOJ’s Criminal Division Fraud Section, said the urgency of tackling pandemic-related fraud is shortening investigations to a span of months rather than years.

“We’re moving much faster these days,” he said Wednesday during a virtual conference held by the American Bar Association. “It’s more covert. We may not see investigations taking two to three years with grand jury subpoenas going out continuously.”

The DOJ is using other, more covert methods, including subpoenas under the Health Insurance Portability and Accountability Act, to move cases along quicker and more efficiently, Beemsterboer said.

When there’s millions of dollars in government funding going out the door and vulnerable beneficiaries are being preyed upon, the DOJ and its federal partners have “taken it upon ourselves to move these investigative models up.”

Pandemic Fraud a Priority

Justice Department leadership has prioritized pandemic-related crime during the past few months, dedicating resources to cracking down on new forms of health-care fraud and the hoarding of personal protective equipment.

Prosecutors have brought several charges for alleged hoarding and price gouging—the focus of a recently created federal task force. Investigators are working to increase their caseload and speed up procedures while grappling with the challenges presented by stay-at-home orders and travel restrictions.

“We’re all much more animated to move these cases faster and to use every tool available to share information as quickly as possible,” Beemsterboer said.

The DOJ continues to utilize its “strike force” model and its partnerships with law enforcement in its fight against health-care fraud, he added. It’s also turning to data analytics to uncover new billing trends that have arisen since the pandemic began.

Beemsterboer said his team is looking at information gleaned from fraud hotlines and tipsters and using its resources in a “very expeditious and efficient way” to make sure they’re focusing on cases of the most concern, such as elder fraud.