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Stuart announces formation of team to combat health care fraud

CHARLESTON, W.Va. — A new innovative approach to solving the health care abuse and opioid crisis has arrived according to United State Attorney Mike Stuart.

Stuart, the U.S. Attorney for the Southern District of West Virginia, announced Wednesday the creation of a team called ARREST has formed, and will focus on health care abuse, recovery, and response.

U.S. Attorney Mike Stuart

“This is an innovative approach linking civil and criminal efforts and enforcement efforts together with federal and state partners for a comprehensive attack on the opioid epidemic and health care fraud,” Stuart said Wednesday at a presser inside the Federal Courthouse in Charleston.

Wes Quigley, the Supervisory Senior Resident Agent for the Federal Bureau of Investigation, Jim Hischar, a Group Supervisor for the Drug Enforcement Administration, Mary Ann Withrow, the Assistant Special Agent in Charge for the U.S Department of Health and Human Services-OIG, Mike Malone, the Director of Medicaid Fraud Control Unit, and Jason Fisher, the Investigative Supervisor for the Medicaid Fraud Control Unit were all on hand for the announcement.

Medicaid fraud is estimated at more than $150 billion annually in the U.S., according to Stuart. While he did not have exact numbers for his district, Stuart said its millions of dollars.

“If folks had any idea of the amount of Medicaid fraud that we prosecute on an annual basis right in this district right here, you’d understand the importance of this,” he said.

“This is a state heavily reliant on government support. I suspect the number is quite high, hundreds of millions of dollars.”

All health care related cases in the Southern District of West Virginia, whether they are the subject of a criminal or civil investigation or enforcement, will be directed through ARREST, per release. Included in the team are the Opioid Fraud and Abuse Detection Unit, Affirmative Civil Enforcement Unit, Appalachian Regional Prescription Opioid Task Force, Medicare and Medicaid Fraud, and Asset Forfeiture efforts related to all healthcare matters.

Stuart said the opioid crisis and abuse of those drugs is an important element in health care fraud.

“We had a lot of pharmacies prescribing far too many pills, millions and millions of pills,” he said. “That shouldn’t have happened and it’s unfortunate it did. Often we go into recovery mode in terms of the abuse we saw. We are going to try and be as vigilant as we can to try and look forward and see what the abuses are as of today.”

Stuart said ARREST is an unparalleled approach to health care related enforcement efforts across all disciplines as it formalizes their commitment to an aggressive, organized and strategic approach to attacking the opioid epidemic as well as targeting health care fraud and abuse both civilly and criminally, per release.

The public can go a long way as well, in helping combat the health care and opioid problems, he said.

“If we rely only on law enforcement to solve all the problems of society, we will never get there,” Stuart said. “We have to work together. I know we are in this with the public, with our communities, with our faith-based community. We have to make sure we are all working together on the same team.”


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