On November 8, 2023, Thomas Tynan, the acting assistant chief of the Department of Justice’s Health Care Fraud Unit, announced in remarks to the Health Care Compliance Association that DOJ will increase its focus on investigating fraud related to Medicare Part C and COVID-19 testing scams. This announcement came on the heels of DOJ’s announcement the prior day that it planned to “substantially” add to its Health Care Fraud Unit, which is already comprised of over 80 prosecutors and dozens of investigators organized into Health Care Strike Forces. It appears DOJ means what it said: in November, DOJ filed a rare criminal indictment in the Southern District of Florida against Kenia Valle Boza arising from misrepresentations Boza made in relation to Medicare Part C. Then, in December, DOJ filed another criminal indictment in the Southern District of New York against Erin Foley and Ted Albin for fraudulent reimbursement and illegal kickbacks in connection with Medicare Part C.
These quick, successive actions from DOJ provide a glimpse into what clients can expect for 2024 when it comes to federal fraud investigations. And while the Valle Boza and Foley-Albin indictments were brought under federal wire fraud and healthcare fraud statutes, DOJ’s announcements and recent indictments also forecast heavier use of the False Claims Act (“FCA”) to investigate fraud relating to Medicare Part C and COVID-19 testing. This is because the FCA is the federal government’s primary tool for...
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