Health Care Fraud and Abuse Enforcement Priorities in Minnesota

United States Attorney for the District of Minnesota, Andrew Luger, spoke at a public event on March 3, 2016, at Mitchell-Hamline School of Law on the topic of health care fraud & abuse enforcement priorities in Minnesota.

Luger began the discussion explaining the resource shortage issue in the white collar arena that he faced when he took office in February 2014, which was caused by three main factors.

• The number of U.S. postal investigators, one of the main investigators of white collar cases, has decreased due to funding problems at the postal service as a whole
• The number of IRS criminal investigators, who also investigate white collar crime, has dwindled.
• The FBI has seen a lot of its resources devoted to terrorism crimes after 9-11.

Luger then turned to the current state of his Minnesota U.S. Attorney’s office.  On the civil side, many of the cases brought by fraud and abuse lawyers involve overbilling.  To identify potential overbilling cases, the office uses contractors to look through billing records.  When the contractors find anomalies indicative of overbilling, they are forwarded to a civil attorney at the Minnesota office.

Luger then highlighted areas of increased interest for his office on the civil side:

• Medicare Part D is as an area his office is now focusing on.  Luger specifically highlighted the billing of high amounts for brand name medications and then actually dispensing generics and compound drugs as issues.

Turning to the criminal side, Luger again highlighted overbilling as a main area of cases for his office.  Luger also highlighted kickbacks as an area of focus using as examples chiropractors and transportation to medical appointments.  Luger also called out day care fraud as an issue.

Luger also explained where he has funneled resources:

• The FBI has recently hired more fraud special agents.
• HHS has recently hired a new health care fraud investigator.
• Luger has just hired a new experienced and aggressive health care fraud attorney in his office after a national search.

Luger asked the crowd to help stop health care fraud explaining that it steals from all of us and expressed his willingness and hope to work with private industry to address this issue.  Luger ended his remarks on his “soapbox” topic of the importance of addressing the opioid and heroin crisis in Minnesota.