DOJ’s Fraud Case Intervention Shows It’s Continuing Individual Prosecution Policy

 

Though administration priorities necessarily change with every presidential transition, the government’s recent intervention into an alleged ambulance services kickback scheme suggests that the DOJ’s priority of holding individuals accountable for health-care fraud will continue at least in the short term.

Just days into the Trump administration, the U.S. Attorney’s Office for the Eastern District of Texas filed its complaint in intervention against an Oklahoma agency and the president who runs it replete with accusations of millions of dollars in bribes, gifts, travel and political corruption to boot (United States ex rel. Dean v. Paramedics Plus, LLC, E.D. Tex., No. 14-cv-203, complaint in intervention 1/23/17).

Of particular note in this False Claims Act action is that the original whistle-blower didn’t name Herbert S. Williamson, president of Oklahoma’s Emergency Medical Services Authority, as a defendant. The allegations against Williamson, which are quite specific concerning his role in organizing an alleged scheme to trade millions in bribes from a Texas hospital system in exchange for an ambulance transport contract that billed Medicare and Medicaid over $100 million, originated with the government’s complaint.

My colleague James Swann talked with a number of former Department of Justice prosecutors recently who were confident that the DOJ would continue to pursue individuals who were culpable in defrauding federal health-care programs, a priority highlighted in a 2015 directive from former Deputy Attorney General Sally Q. Yates (informally known as the Yates memo). Although the investigation into Williamson personally almost certainly began prior to the 2016 election, the DOJ’s complaint showcases that this policy priority has now been inherited at least by default by the Trump administration.

Health-care attorneys will be looking at whether the pace of investigations and individual prosecutions for health-care fraud changes as the new administration assumes the responsibility of prosecuting this case, and in shepherding other ongoing investigations of individuals in U.S. attorney offices around the country.

Read more about the case in my story here.

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