Friday, February 22, 2019

United States Attorney Mike Stuart Forms Health Care Abuse, Recovery and Response Team ("ARREST") To Intensify Response to Opioid Epidemic and Health Care Fraud


ARREST Team is New Approach to Solving Crisis

Medicaid Fraud Estimated at More Than $150 Billion Annually in U.S.

CHARLESTON, W.Va. – United States Attorney Mike Stuart, joined by Assistant Special Agent in Charge Mary Ann Withrow, U.S. Department of Health and Human Services Office of Inspector General (OIG), Supervisory Senior Resident Agent Wes Quigley, Federal Bureau of Investigation (FBI), Group Supervisor Jim Hischar, Drug Enforcement Administration and Director Mike Malone and Investigative Supervisor Jason Fisher, West Virginia Medicaid Fraud Control Unit, announced the formation of a Health Care Fraud Abuse, Recovery and Response Team (ARREST), an innovative approach linking civil and criminal enforcement efforts together in a comprehensive attack on the opioid epidemic.

All health care related cases in the Southern District of West Virginia, whether they are the subject of criminal or civil investigation or enforcement, will be directed through ARREST.  Included within the purview of the Team are the:

    Opioid Fraud and Abuse Detection Unit;
    Affirmative Civil Enforcement Unit;
    Appalachian Regional Prescription Opioid Task Force;
    Medicare and Medicaid Fraud; and
    Asset Forfeiture efforts related to all healthcare matters.

“The formation of ARREST is unique in the country,” said United States Attorney Mike Stuart.  “To my knowledge, this is the first district in the country that has broken down all barriers between civil and criminal efforts to ensure a comprehensive and intense approach to ending the opioid crisis and rooting out health care related fraud.  Health care and Medicaid fraud is a crisis in the country, for taxpayers, and for rate payers, with an estimated $150 billion in fraud annually.  I intend to turn a microscope on fraudulent activities in the Southern District of West Virginia.”

“ARREST is simple,” continued United States Attorney Mike Stuart.  “We are establishing a level of teamwork, cooperation, and communication that is an unparalleled approach to health care related enforcement efforts across all disciplines.  The creation of ARREST formalizes our commitment to an aggressive, organized and strategic approach to attacking the opioid epidemic as well as targeting health care fraud and abuse both civilly and criminally.”

“The FBI and our partners are using every tool we have to fight health care fraud and opioid abuse in West Virginia,” said Special Agent in Charge Robert Jones. “The FBI works tirelessly to make sure medical professionals who contribute to the drug crisis tearing families apart and putting patients at risk are brought to justice."

“The newly formed team will combine the talents, dedication, and resources of federal law enforcement and the State of West Virginia to fight healthcare fraud and dismantle drug diversion,” said Maureen R. Dixon, Special Agent in Charge for the Department of Health and Human Services, Office of Inspector General (HHS-OIG). “We look forward to working with the U.S. Attorney and our fellow law enforcement partners to take illegal prescriptions drugs off our streets, protect Medicare and Medicaid beneficiaries from harm, and ensure the integrity of U.S. taxpayer funds.”

“The Drug Enforcement Administration remains committed to fighting the opioid crisis with every available resource,” said D. Christopher Evans, Special Agent in Charge of DEA’s Louisville Field Division, which covers West Virginia, Kentucky, and Tennessee.   “The strategic partnership created by the ARREST initiative will help DEA and our partners better channel those resources to great effect for the people of West Virginia,” Evans added.

“The Medicaid Fraud Control Unit of the Office of Inspector General within the West Virginia Department of Health and Human Resources is proud to be part of the U.S. Attorney’s Health Care Abuse, Recovery and Response Team,” said Michael Malone, Director of the Medicaid Fraud Control Unit. “We look forward to playing an important role in combating the opioid crisis and protecting the integrity of all health care programs for West Virginia citizens and their tax dollars.”

Assistant United States Attorney Alan McGonigal is serving as the Chair of ARREST.  He will work in conjunction with Assistant United States Attorney Haley Bunn, who will head up the team’s criminal drug diversion efforts, and Assistant United States Attorney Meredith George Thomas, who will oversee the team’s criminal health care fraud matters.  In addition, a Health Care Fraud Prevention Partnership is being established, which consists of voluntary public/private partnerships between the federal government, state agencies, law enforcement, private health insurance plans, employer organizations and health care anti-fraud associations.  The purpose of the partnership is to exchange data and information between partners to help improve capabilities to fight fraud, waste and abuse in the health care system.

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