[co-author: Alise Matherson]

In May 2021, Attorney General Merrick Garland announced the creation of the COVID-19 Fraud Enforcement Task Force. The Task Force is comprised of more than a dozen federal agencies that are investigating and prosecuting pandemic-related fraud, including Department of Labor, Social Security Administration, and the IRS. The Task Force’s mission includes detecting and disrupting future fraud and supporting the investigation and prosecution of culpable defendants. The DOJ announced that the Task Force charged nearly 600 defendants to date with crimes involving over $600 million in 56 federal districts around the country. Some of the coordinated nationwide takedowns involved 35 defendants in the healthcare space and more than $290 million in false billing.

The DOJ’s criminal enforcement activities have focused thus far on individuals and businesses taking advantage of the country’s response to the COVID-19 pandemic by targeting government funds. Some defendants induce patients to provide personal information for use in submitting false claims for additional unrelated, unnecessary, and more expensive tests. Other fraud schemes have included committing unemployment insurance fraud and manufacturing fake COVID-19 vaccination cards. In the coming months, the DOJ predicts numerous civil enforcement actions with respect to its pandemic fraud prevention, detection, and prosecution efforts.

To get ahead of this ramped up wave of enforcement and audit activity, healthcare and life science stakeholders should carefully evaluate and inventory their involvement with COVID-19 related programs. Health care providers should also conduct internal audits and investigations related to compliance with the programs, and finally, address any potentially fraudulent activity or misconduct detected to ensure compliance with the ever-changing terms and conditions of these government programs.

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