Updated on: August 26, 2020

Feds of a Feather Investigate Together

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Original story posted on: August 25, 2020

Much like episodes of Law & Order, news stories often provide the ideas for my articles. Events off the East Coast last week offered a quick reminder about the importance of recognizing the significance of contacts with certain government investigators. 

Last week, former presidential advisor Steve Bannon was arrested on a yacht off the coast of Connecticut. Since the arrest happened on a boat, it’s not surprising that the Coast Guard was involved. But who else was involved in the arrest? This may be surprising, but it wasn’t the FBI. Instead, postal inspectors joined the Coast Guard.   

While you may think of the U.S. Postal Service primarily for moving the mail, postal inspectors often spearhead mail and wire fraud investigations. If you’re ever visited by a postal inspector, it’s a big deal. And postal inspectors aren’t the only government agents whose titles may be misleadingly innocent-sounding. A wide range of government agents lack the cache and pop culture appeal of FBI agents, but their impact can be just as significant. 

Agents from the U.S. Railroad Retirement Board or the Defense Criminal Investigative Service (DCIS) commonly appear in healthcare fraud investigations. At least DCIS has “criminal” in its name, making their legal clout a bit more obvious. One might think the Railroad Retirement Board is responsible for saving people tied to the tracks in some cartoon caper. In fact, they help the government bring criminal charges for healthcare insurance fraud. 

Perhaps you have heard references to “MFCUs.”  Both the acronym and its pronunciation (“Mafookoos”) might sound like they belong in a dirty joke, but these State Medicaid Fraud Control Units have the ability to conduct criminal investigations. It’s not all that unusual to see agents from the Food and Drug Administration (FDA), Drug Enforcement Administration (DEA), or, in rare instances, the Nuclear Regulatory Commission pop up in a healthcare fraud investigation. 

The main lesson is any time you see an agent from any government agency appear in an investigation, assume that it is a very big deal.

Most insurance companies have fraud units staffed by people with titles not unlike the government agents. While these “special agents” or “fraud investigators” from private companies can’t directly lock you up, don’t be too quick to dismiss them. It’s not uncommon for private insurers to work hand in hand with government agents. I’ve seen private insurance companies turn over entire files to government investigators. In one case, the insurance company sent undercover patients who recorded their interactions with a surgeon and then turned over the videos to the government. 

The bottom line is that you don’t want to underestimate the power of lesser-known government agencies. While they may not appear in as many TV shows, they can definitely get you in the headlines. 

Programming Note: David Glaser is a permanent panelist on Monitor Mondays. Listen to his live reporting every Monday at 10-10:30 a.m. EST.

David M. Glaser, Esq.

David M. Glaser, Esq., is a shareholder in Fredrikson & Byron’s Health Law Group. David helps clinics, hospitals, and other healthcare entities negotiate the maze of healthcare regulations, providing advice about risk management, reimbursement, and business planning issues. He has considerable experience in healthcare regulation and litigation, including compliance, criminal and civil fraud investigations, and reimbursement disputes. David’s goal is to explain the government’s enforcement position and to analyze whether the law supports this position. David is a popular panelist on Monitor Mondays and a member of the RACmonitor editorial board.

 

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