U.S. Attorney's Office Announces the Formation of Multi-Agency Health Care Fraud Task Force

COLUMBIA, S.C. - Together with state and federal partners, U.S. Attorney Adair F. Boroughs announced the formation of the Palmetto Health Care Fraud Task Force (PHCF Task Force), which has been created as a dedicated task force to combat health care fraud and recover taxpayer money in the District of South Carolina through criminal and civil actions. Other agencies that have joined the PHCF Task Force include investigators from the Department of Labor and the South Carolina Attorney General's Medicaid Fraud Control Unit.

In February 2023, the FBI, U.S. Attorney's Office for the District of South Carolina, and other federal, state, and local agency partners began meeting as part of a Health Care Fraud Working Group with the goal of combatting health care fraud in the District of South Carolina. The PHCF Task Force was created after the FBI and the U.S. Attorney's Office saw great success from the Working Group meetings. The creation of the PHCF Task Force demonstrates an increased effort to bring to justice those who defraud the health care system, to deter future health care fraud and abuse, and to promote trust in the healthcare system. Additional resources available to the PHCF Task Force will include the FBI's Data Analytics Response Team (DART), numerous forensic accountants, and Intelligence Analysts from various agencies, which all will promote efficiency in prosecuting cases.

Health care fraud is an enormous burden on South Carolina taxpayers. In 2023, taxpayer funded healthcare programs spent approximately $23 billion in South Carolina alone. Although it is difficult to approximate the amount of money lost to waste, fraud, and abuse each year, the Government Accountability Office estimates it could be as much as 10% of money spent. The PHCF Task Force will better equip the United States to detect wrongdoers and recoup money lost to fraud in South Carolina-which costs taxpayers billions each year.

The PHCF Task Force and agencies involved in the Health Care Fraud Working Group will meet regularly to aggressively investigate allegations of false billings, COVID-19 fraud, violations of the Anti-Kickback Statute, and other schemes that victimize patients, health care providers, private insurers, and government insurers, such as Medicare, TRICARE, and Medicaid, in the District of South Carolina.

"Health care fraud impacts our citizens, both as patients and taxpayers," said Adair F. Boroughs, U.S. Attorney for the District of South Carolina. "The Palmetto Health Care Fraud Task Force demonstrates our commitment to working with our partners to protect those seeking quality medical care and the federal programs meant to support them. The U.S. Attorney's Office for the District of South Carolina commends our partners for the creation of the Palmetto Health Care Fraud Task Force and will continue to vigorously prosecute and pursue those who abuse and take advantage of health care programs."

"Fraud committed within our health systems affects everyone and weakens public trust," said Steve Jensen, Special Agent in Charge of the FBI Columbia Field Office. "The FBI created the PCHF Task Force to bolster the local, state, and federal posture against health care fraud, and it will enhance our investigative approaches to hold offenders accountable. We appreciate our federal and state partners that have joined the task force in this effort."

"We welcome the PHCF Task Force and will continue to assist investigative partners combatting health care fraud," said Tamala E. Miles, Special Agent in Charge with the Department of Health and Human Services, Office of Inspector General (HHS-OIG). "Our unwavering commitment at HHS-OIG remains steadfast in protecting Medicare, Medicaid, and the well-being of their beneficiaries from fraudulent schemes. The impact of defrauding federal health care programs diverts crucial resources from those deserving of vital medical attention and will not be tolerated."

The U.S. Attorney's Office for the District of South Carolina anticipates broader enforcement as a result of the PHCF Task Force, building on its past success. For example, in April 2019, the District of South Carolina announced its participation in a nationwide operation aimed at dismantling one of the largest Medicare fraud schemes in history. In March 2024, one of the Defendants, Andrew Chmiel, was sentenced to nine years in federal prison for his role in this scheme. The District of South Carolina also recently announced the successful prosecution of Jeffrey Brooks for submitting false durable medical equipment claims. Mr. Brooks pled guilty to conspiracy to commit health care fraud and was sentenced to seven and a half years in federal prison. He also paid $850,000 to the United States as part of a civil settlement.

If you suspect healthcare fraud, please report it by phone at 1-800-CALL-FBI (1-800-225-5324) or submit a tip at tips.fbi.gov.

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