What is the role of the Health Care Fraud Unit?

Healthcare fraud involves various illegal activities that impact the healthcare system. Dedicated agencies throughout all levels of government investigate these issues. One of the major players is the Health Care Fraud Unit within the U.S. Department of Justice's Fraud Section.

Uncovering fraud

The Health Care Fraud Unit assists with uncovering complex healthcare fraud. It has over 80 prosecutors who have experience in this type of law working to fulfill its mission. The unit gathers evidence through investigations into suspicious activities, such as billing irregularities, kickbacks and unnecessary medical procedures. It also conducts meticulous analysis of financial records, medical documents and witness testimonies to assist with building strong cases.

Identifying trends

The Health Care Fraud Unit also works to identify trends and patterns indicative of broader fraudulent schemes. It does this by analyzing data from various sources to uncover systemic issues within the healthcare system and more effectively target fraud schemes.

Collaborating with others

The unit collaborates with other law enforcement agencies and regulatory bodies to bring cases to court. This may involve working closely with federal prosecutors, state attorneys general and investigative agencies, such as the FBI and the Department of Health and Human Services. By leveraging their expertise and resources, these partnerships enhance the unit's ability to effectively uncover fraudulent activities.

Providing education

The unit also educates healthcare providers and the public about the consequences of fraud through outreach efforts and awareness campaigns. Such information can also prevent an individual from having to defend against fraud charges because they unknowingly had involvement. The aim is to empower stakeholders with knowledge and resources to create a culture of accountability and integrity. The Health Care Fraud Unit is aggressive at its duties. It seeks to ensure fraud becomes nonexistent within the healthcare industry.