New unit formed to combat health care fraud in West Virginia
WHEELING, WEST VIRGINIA – A new initiative to combat health care fraud in West Virginia was launched today in Wheeling, according to United States Attorney William Ihlenfeld.
State and federal agencies gathered at the U.S. Attorney’s office this morning for the first meeting of the Mountaineer Health Care Fraud Strike Force, a unit that will take a data-driven approach to uncovering waste and abuse. Representatives from seven different agencies discussed fraudulent billing patterns and new targets were identified as a result.
In addition to its analytical work, the Strike Force will engage with providers and insurers so that there is a better understanding on how to recognize and report health care fraud.
“The time I spent in the private sector opened my eyes to the scope of the health care fraud that is occurring in West Virginia,” said Ihlenfeld. “It made me realize that more can and should be done by law enforcement, which is why this new group has been formed.”
Ihlenfeld stressed the importance of whistleblowers and the impact that they can have upon uncovering fraud.
“Oftentimes the first person to witness fraud is an employee of a hospital or a doctor’s office,” Ihlenfeld remarked. “Those who blow the whistle and expose conduct that the government was not able to detect on its own are awarded a portion of the amount recovered, and those awards can be substantial."
Last year, a whistleblower was awarded $10 million in the matter of U.S. ex rel. Longo v. Wheeling Hospital, Inc. Read more here: https://www.justice.gov/usao-ndwv/pr/west-virginia-hospital-agrees-pay-50-million-settle-allegations-concerning-improper
“Fraud and abuse take critical resources out of our health care system and contribute to rising costs for everyone,” said FBI Special Agent in Charge Mike Nordwall. “It costs U.S. taxpayers tens of billions of dollars annually. The FBI, along with state, local and federal partners, are working side by side to help stop West Virginians from having to absorb the costs associated with health care fraud. I hope the community will use this tip line to aid us in our efforts to hold those who commit fraud accountable.”
“The newly formed team will combine the talents, dedication, and resources of federal law enforcement and the State of West Virginia to fight health care fraud, waste, and abuse,” said Maureen R. Dixon, Special Agent in Charge for the Department of Health and Human Services, Office of Inspector General (HHS-OIG). “We look forward to working with our law enforcement partners in this collaborative initiative to prevent and detect health care fraud, hold wrongdoers accountable, and ensure appropriate use of taxpayer funds.”
Members of the Mountaineer Health Care Fraud Strike Force include agents, officers and prosecutors from the Federal Bureau of Investigation (FBI), the U.S. Department of Health and Human Resources (HHS), the Drug Enforcement Administration (DEA), the U.S. Department of Defense, the West Virginia Medicaid Fraud Control Unit, the West Virginia Offices of Insurance Commission, and the United States Attorney’s Office.