VA, Justice Department join forces to focus on healthcare fraud

Abbie Bennett
October 02, 2019 - 1:15 pm
MedicalFraud

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After multiple allegations of fraud and medical crimes at the Department of Veterans Affairs medical facilities across the country, the VA and Justice Department are joining forces. 

Investigations already are ongoing in cases of bribery and fraud at VA. Charges have been levied against others for stealing pain medication from veterans. One former VA doctor is even accused of manslaughter.

In response, VA's Inspector General and the Justice Department have created the VA Health Care Fraud Task Force. 

The task force will include OIG's investigations of health care fraud at VA with the Justice Department's experience prosecuting health care fraud through its Medicare Fraud "Strike Force," according to a news release from VA's OIG. 

The task force plans to begin by focusing on investigating and prosecuting health care fraud in VA's growing Community Care program, where the agencies see particular potential vulnerabilities.

With the MISSION Act launch in June, VA expanded veterans' community care, allowing patients more opportunities to seek care at private health care providers in VA's network. But that expansion of care introduces more variables that require oversight to protect veterans and federal dollars.

“Combating health care fraud is one of our highest priorities at VA OIG,” VA Inspector General Michael J. Missal said in a statement. “This task force sends a clear message to anyone considering committing health care fraud at VA – we will protect our veterans’ health care system at all costs.” 

The task force has a big job on its hands. VA operates the largest health care system in the U.S., providing care to about 9 million veterans each year at more than 1,200 facilities, according to VA. 

The Justice Department's Fraud Section already has 15 strike forces in 24 areas of the country to respond to fraud crimes, partnering with the U.S. Attorney's Offices, FBI and Department of Health and Human Services' OIG. 

Justice's Medicare Fraud Strike Force has charged nearly 4,200 defendants who allegedly tried to bill Medicare for a collective $19 billion. VA's OIG and Justice plan to use that strike force as a model.

“It is beyond the pale when individuals commit fraud against health care programs designed to assist the men and women who have served in our nation’s military,” said Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division. “This new task force leverages the proven success of the Department’s Strike Force model and will aggressively target fraud in the VA’s expanding health care programs.”

The announcement also included a list of 13 investigations of VA crimes this year, including: 

  • Manslaughter charges against a former Arkansas VA pathologist accused of falsifying records to conceal his alleged on-duty substance abuse issues;
  • The owner of a Colorado private health care company who allegedly paid $1 million in bribes to a VA employee to funnel VA referrals to his company;
  • A former VA nurse in Massachusetts who allegedly stole morphine from hospice patients; 
  • Six care claims processors in Ohio charged with allegedly collecting overtime pay for hours they never worked;
  • The owner of a home healthcare company in West Virginia accused of falsely billing VA for services to a Spina Bifida beneficiary that she never provided; 
  • Charges against a former Wisconsin VA nurse practitioner for alleged opioid prescription fraud.

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Reach Abbie Bennett: abbie@connectingvets.com or @AbbieRBennett.

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