Bringing the HEAT: DOJ and HHS Create Heath Care Fraud Prevention and Enforcement Action Team

May 22, 2009

On May 20, 2009, the Department of Justice (DOJ) and Department of Health and Human Services (HHS) announced the creation of the Health Care Fraud Prevention and Enforcement Action Team (HEAT), a new interagency investigation and enforcement team. The creation of HEAT signifies an increased focus by DOJ and HHS on combating health care fraud.

HEAT, which will include senior officials from DOJ and HHS, will invest in technology and data sharing measures and will also undertake several initiatives designed to prevent Medicare fraud, including:

  • Increased site visits to potential suppliers of durable medical equipment to prevent imposters;
  • Increased provider training on Medicare compliance;
  • Improved data sharing to identify patterns that lead to health care fraud; and
  • Strengthened monitoring activities to ensure Medicare Part C (Medicare Advantage plans) and D (prescription drug programs) compliance and enforcement.

DOJ and HHS also announced an expansion to the operations of the existing joint DOJ/HHS Medicare Strike Force, which fights fraud on a targeted local level.

The formation of HEAT comes amid a recent upward trend in health care fraud-related investigations and prosecutions, and sends a strong message that this area is a key priority for federal regulators and law enforcement under the Obama administration.

McGuireWoods' Government Investigations group has extensive experience in health care related matters, ranging from the creation of compliance regimes to the defense of federal criminal investigations. For more information about McGuireWoods' capabilities and resources in this and other areas of health care fraud compliance and criminal defense, please contact the authors.

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