May 21, 2018

May 21, 2018

Subscribe to Latest Legal News and Analysis

May 18, 2018

Subscribe to Latest Legal News and Analysis

US Attorney’s Office in Chicago Announces Creation of Health Care Fraud Unit

Acting US Attorney Joel Levin says the new dedicated unit aims to bring “even greater focus, efficiency, and impact to our efforts in this important area.”

The US Attorney’s Office for the Northern District of Illinois recently announced the creation of a Health Care Fraud Unit—a team of five assistant US attorneys devoted to prosecuting all types of healthcare fraud cases, including fraudulent billing schemes and diversion of controlled substances.

The announcement came just days after the largest US Department of Justice national healthcare fraud enforcement “takedown” action against 412 defendants across 41 federal districts for the alleged participation in schemes involving over $1 billion in fraudulent healthcare billing. Fifteen individuals, including two Chicago-area licensed physicians, are facing federal criminal charges and potential Office of Inspector General (OIG) exclusion as a result of this action. 

Nationwide, US Attorney offices have a major role in healthcare fraud enforcement. In Fiscal Year 2016 alone, US Attorney offices opened 975 new criminal healthcare fraud investigations and 930 new civil healthcare fraud investigations.[1] 

While the US Attorney’s Office for the Northern District of Illinois has a long history of prosecuting healthcare fraud cases, the creation of a dedicated unit within the office may have a number of quantifiable effects, including the following:

Rise in Criminal Investigations and Prosecutions. The dedicated unit, comprised of criminal prosecutors, will focus on the criminal prosecution of entities and individuals when the alleged healthcare fraud rises to the level of criminal culpability. As such, there likely will be a rise in investigative activity that includes attempted interviews of potential targets, subjects, or witnesses by government agents; the issuance of grand jury subpoenas; and the execution of search warrants.

In addition, the criminal prosecutors undoubtedly will work closely with government attorneys assigned to the civil division and—to the extent permitted in accordance with grand jury secrecy rules—share certain information with civil division attorneys.

Rise in Enforcement Investigations and Actions. With increased focus, resources, and the sharing of information obtained from criminal investigations, there also may be a rise in the number of civil investigative demands issued to companies in the healthcare industry that are suspected of fraud, waste, and abuse. The US Attorney’s Office for the Northern District of Illinois may become more proactive in its efforts—alongside the OIG—to increase the collection of civil penalties against healthcare organizations and executives.     

Rise in Qui Tam Suits. With a dedicated Health Care Fraud Unit, the Northern District of Illinois may become a more attractive venue for whistleblowers seeking to recover under the False Claims Act for alleged fraud, waste, and abuse.

The new Health Care Fraud Unit will operate within the criminal division of the US Attorney’s Office for the Northern District of Illinois. Assistant US Attorney Heather McShain will lead the unit, and Assistant US Attorney Stephen Chahn Lee will serve as senior counsel.


[1] See The Department of Health and Human Services and The Department of Justice Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2016.

Copyright © 2018 by Morgan, Lewis & Bockius LLP. All Rights Reserved.

TRENDING LEGAL ANALYSIS


About this Author

Tinos Diamantatos, Complex Civil Litigator, Morgan Lewis, trial attorney
Partner

A seasoned trial lawyer and former federal prosecutor, Tinos Diamantatos represents organizations and individuals in litigation, government and internal investigations, and securities enforcement proceedings. This includes white collar crime, litigation related to government investigations, qui tam litigation, and complex civil litigation. He also counsels clients on compliance issues. Before joining Morgan Lewis, Tinos served with distinction as a federal prosecutor in the US Attorney’s Office for the Northern District of Illinois.​

312-324-1145
Eric Sitarchuk, Morgan Lewis, litigation attorney
Partner

Eric W. Sitarchuk represents clients in government investigations and white-collar litigation. With 30 years of experience in this area, he represents clients in a wide variety of white-collar criminal matters, False Claims Act (FCA) and qui tam litigation, and Foreign Corrupt Practices Act (FCPA) and other complex federal and state investigations. Working with boards of directors, audit committees, and corporate management, Eric has conducted numerous internal investigations, and advised on the creation and implementation of corporate compliance and ethics programs. He serves as chair of the firm’s white collar and corporate investigations practice.

215.963.5840
Howard Young, Morgan Lewis, Healthcare lawyer
Partner

A nationally recognized leader in healthcare fraud and abuse and regulatory issues, Howard J. Young leads the Morgan Lewis healthcare practice and co-leads the healthcare industry initiative where he advises a range of healthcare clients on government investigations, regulatory, and transactional matters. Healthcare organizations turn to Howard to address their most critical legal, compliance and strategic business issues and to assist with internal and government investigations and self-disclosures. Howard regularly advises investors, including private equity firms, on...

202-739-5461
Megan Braden, Morgan Lewis, Litigation attorney
Associate

Megan R. Braden represents clients in complex litigation matters, government and regulatory investigations, and securities enforcement proceedings. Handling all phases of litigation, Megan works with clients in a variety of industries and has experience defending pharmaceutical and hospital systems in False Claims Act (FCA) actions, representing product manufacturers in insurance coverage, breach of contract and product liability matters, defending financial and consumer services companies in class actions alleging violations of federal and state statutes, and...

312-324-1738