Health Care Fraud Section

The Fraud Division's Health Care Fraud Section is comprised of over 75 experienced white-collar prosecutors dedicated exclusively to prosecuting the nation’s most complex health care fraud matters and criminal conduct involving the illegal prescribing and dispensing of opioids and other controlled substances. The Section's core mission is to protect the public fisc, involving health care benefit programs such as Medicare, Medicaid, and TRICARE, and to protect patients from egregious fraudulent schemes that result in patient harm, including the overprescribing of controlled substances.  The Section routinely prosecutes defendants who orchestrate schemes that result in the loss of hundreds of millions of dollars, the distribution of thousands of controlled substance pills, and complex money laundering, tax, and other associated financial crime offenses.

The Health Care Fraud Section is a leader in using advanced data analytics and algorithmic methods to identify newly emerging health care fraud schemes and to target the most egregious fraudsters.  The Section's team of dedicated data analysts work with prosecutors to identify, investigate, and prosecute cases using data analytics.  This novel approach has led to some of the Section’s largest cases and initiatives.  

The Health Care Fraud Section employs a recognized and successful Strike Force Model for effectively and efficiently prosecuting health care fraud and illegal prescription cases across the United States.  Section prosecutors currently operate in nine Strike Forces across the country. The Strike Force Model centers on a cross-agency collaborative approach, bringing together the investigative and analytical resources of the Fraud Division, Federal Bureau of Investigation, U.S. Department of Health and Human Services-Office of the Inspector General, Centers for Medicare & Medicaid Services, Drug Enforcement Administration, Defense Criminal Investigative Service, Federal Deposit Insurance Corporation-Office of the Inspector General, Internal Revenue Service-Criminal Investigations, Department of Labor-Office of the Inspector General, United States Postal Service-Office of the Inspector General, Veterans Administration-Office of the Inspector General, and other agencies.  

The Health Care Fraud Section conducts more trials than any other component of the Department of Justice.  Its prosecutors are known for conducting the largest and most complex health care fraud trials in districts located across the country.