WASHINGTON - Since the destruction of the World Trade Center last year, the FBI has diverted its attention from healthcare fraud to track anti-terrorist activities. As a result, a significant number of HME fraud cases involving FBI investigators have ground to a halt, say industry attorneys.
"It's good and bad," said Jeff Baird, an attorney with Amarillo, Texas-based Brown & Fortunato. "On the one hand it is good because it means fewer HMEs are in trouble. But as a general rule, when there is a criminal case brought against an HME company usually it should be brought, and that is good for the industry because it helps root out the bad apples."
Since the attack on Sept. 11, 2001, three of Brown & Fortunato's cases involving FBI investigations have been put on hold. In one instance, the investigating FBI agent transferred to Pakistan to help track the money flow of Osama Bin Laden's terrorist network, Baird said.
"That will make investigating healthcare fraud a little less exciting when he comes back," quipped Cara Bachenheimer, a healthcare attorney with Epstein Becker & Green in Alexandria, Va.
Epstein has noticed a fall off in FBI investigations similar to Brown & Fortunato, and the bureau has told them it's due to their role in the war on terrorism.
"That may be a plausible explanation," Bachenheimer said. "Or it could just be government bureaucracy or inertia or more difficult than they thought it would be. There are any number of explanations. Obviously we don't think they have a whole lot of evidence."
The FBI's shift in focus is not unprecedented. In the early and mid-1990s, as the Cold War ended and the war of drugs died down, the bureau began playing a more active role in investigating healthcare fraud.
But while the FBI has diverted its gaze, the Department of Health and Human Services and OIG have not, said Corinne Parver, a healthcare attorney with Dickstein Shapiro Morin & Oshinsky.
"People shouldn't become lackadaisical and lose their focus on fraud and compliance," Parver said. "That would be a sad mistake."
Indeed, the decreased FBI involvement may slow down investigations into kickback and other fraud cases that involve interviewing a lot of people. But for cases involving allegations of fraudulent billing, the government doesn't need to conduct extensive interviews and investigations. All it needs is someone who can read patient charts and billing records, said attorney Tom Antone.
"The government enforcement is still very aware and interested and focused on healthcare fraud, and I don't think that anyone should take for granted that because we have a internal terrorism crisis that they can relax," Parver said. HME