DOJ’s New Opioid Fraud And Abuse Detection Unit To Investigate Physicians And Pharmacists For Opioid-Related Health Care Fraud
By: John A. Schwab
Attorney General Jeff Sessions announced the formation of a DOJ pilot program to combat the opioid epidemic devastating communities across the country. The program, named the Opioid Fraud and Abuse Detection Unit, will prosecute opioid-related health care fraud using data analytics to identify and prosecute individuals allegedly contributing to the epidemic.
In remarks to the Columbus Police Academy in early-August, Attorney General Sessions announced that the newly formed Opioid Fraud and Abuse Detection Unit will analyze data like prescriptions and billing records to investigate and prosecute health care fraud related to prescription opioids. As part of the program, DOJ is funding twelve AUSA’s for a three-year term to focus solely on opioid-related offenses like pill mill schemes and pharmacies that illegally dispense prescription opioids for illegitimate purposes. General Sessions said that in the crosshairs of the Detection Unit are “doctors, pharmacies, and medical providers who are furthering this epidemic to line their pockets.”
The pilot program will focus its efforts on the twelve communities hardest hit by the opioid epidemic, including local jurisdictions like the Western District of Pennsylvania, Southern District of Ohio, and Southern District of West Virginia.
For the Record
Attorney General Jeff Sessions: “I have created this unit to focus specifically on opioid-related health care fraud using data to identify and prosecute individuals that are contributing to this opioid epidemic. This sort of data analytics team can tell us important information about prescription opioids—like which physicians are writing opioid prescriptions at a rate that far exceeds their peers; how many of a doctor’s patients died within 60 days of an opioid prescription; the average age of the patients receiving these prescriptions; pharmacies that are dispensing disproportionately large amounts of opioids; and regional hot spots for opioid issues.”
“With this data in hand, I am also assigning 12 experienced prosecutors to focus solely on investigating and prosecuting opioid-related health care fraud cases in a dozen locations around the country where we know enforcement will make a difference in turning the tide on this epidemic. These prosecutors, working with FBI, DEA, HHS, as well as our state and local partners, will help us target and prosecute these doctors, pharmacies, and medical providers who are furthering this epidemic to line their pockets.”
The Take Home
Unlike DOJ’s typical prosecution of drug crimes, which largely focuses on street-level dealers and their suppliers, the Opioid Fraud and Abuse Detection Unit will target physicians, pharmacists, and providers for health care fraud related to prescription opioids.
If you are a physician, pharmacist or health care provider and need the assistance of an attorney, please do not hesitate to contact us today.