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Geoffrey StarksCounsel to the Deputy Attorney GeneralOffice of the Deputy Attorney General
FY 14-15: Agency Priority Goal
Financial and Healthcare Fraud
Priority Goal
Goal Overview
The recent financial crisis, which has impacted every American, has resulted in fraud and deception in the finance and housing markets as well as fraudulent schemes that misuse the public’s unprecedented investment in economic recovery. Criminals who commit mortgage fraud, securities and commodities fraud, and other types of fraud relating to the response to the economic crisis, victimize the American public as a whole. Similarly, those who defraud Medicare, Medicaid, and other government health care programs defraud every American. In particular, health care fraudsters take critical resources out of our health care system—thus contributing to the rising cost of health care for all Americans and endangering the short-term and long-term solvency of these essential health care programs. The Department will continue to address these critical problems by vigorously investigating and prosecuting both health care fraud and financial fraud, in order to protect American businesses, consumers, and taxpayers.
Strategies
The investigations of complex health care and financial fraud schemes necessarily require a greater commitment of time and resources than typical fraud matters. Such investigations often require a mastery of the regulatory scheme governing the underlying government program at issue, the interviews of a multitude of witnesses, analyses of massive amounts of documentary, financial material, and the coordination of numerous federal and state law enforcement authorities with responsibility over such matters. Despite the complexity of these cases, the need to bring wrongdoers to justice as rapidly as possible, and returning to the public fisc the losses incurred as a result of such schemes, dictate that these matters are moved in as expeditious a manner as possible.
The Department will continue to vigorously investigate and prosecute both health care fraud and financial fraud, in order to protect American businesses, consumers, and taxpayers. As we balance limited resources against increasing demands, reducing the number of investigations pending 2 years or greater calls for smart management. Bringing investigations to resolution more quickly will deter similar criminal conduct and ensure that our limited resources are expended appropriately. Pending accurate investigation lists will be provided regularly to all participating litigators in order to focus attention on those investigations that need resolution.
Over the last several years, the number of investigations pending over 24 months has increased by approximately 6 percent each year. The goal not only seeks to reverse this trend by eliminating two years of a projected annual increase, but will also result in an additional 3 percent decrease from the baseline year. DOJ will thereby avert a double digit increase from the baseline that would have otherwise occurred in the absence of this goal.
- Investigations “pending” refer to investigations where no charging or filing decision has yet occurred.
Progress Update
The Department made significant progress in reducing the number of financial and healthcare fraud investigations pending longer than 2 years during the FY 2014-2015 time period. Through the end of 4th quarter FY 2015, the number of pending investigations was 4,801. The goal for this measure is to be at or below the annual target. The end-of-year 4th quarter actual figure is 4% below the FY 2015 annual target of 4,997. Moreover, the FY 2015 end-of-year actual is 7% below the FY 2013 baseline figure of 5,152 for this priority goal. Over the past two years, the numbers have trended downward due to greater awareness of the “aging matters” by United States Attorney Offices (USAOs). The data concerning health care fraud and financial fraud matters which have been pending for 24 months or more are now posted on each USAO’s internal data page. The data page is updated on a quarterly basis.
Milestone: EOUSA will develop a brief video for USAO financial fraud and healthcare fraud coordinators to update them on the status of the goal, and ask the coordinators to review their districts’ aging matter data on the Data Analysis website. The video will be posted on the EOUSA intranet.
• Met - The taping of the video was completed in 4th quarter and has been posted in the EOUSA Intranet site. In addition, all financial-healthcare fraud coordinators were notified through e-mail reminding them of the importance of reviewing their aged pending case loads.
Milestone: CRM will develop an open investigations quality check in the Division’s Performance Dashboard. This will provide an easy to read, real-time user interface, which will enable informed decisions to be made.
• Completed - CRM completed (2nd quarter) the automation of real-time reporting of financial and healthcare fraud investigations pending longer than 2 years through CRM’s Performance Dashboard.
Overall, the Department will continue to vigorously investigate and prosecute both financial fraud and health care fraud related cases, in order to protect American businesses, consumers, and taxpayers. In September 2015, the Department issued a new policy guidance to all Department prosecutors and civil litigators to require that, if a company wants any credit for cooperation, it must identify all individuals involved in the wrongdoing, regardless of their position, status, or seniority in the company, and provide all relevant facts about their misconduct. Fundamentally, this guidance ensures that all Department attorneys are consistent in using our best efforts to hold individual wrongdoers accountable.
Next Steps
No Data Available
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Performance Indicators
Reduce by 3 percent the number of financial and healthcare fraud investigations pending longer than 2 years
Contributing Programs & Other Factors
Internal Partners:
- Civil Division
- Criminal Division
- Executive Office of the U.S. Attorneys
- Federal Bureau of Investigations
External Partners
- Health and Human Services/Office of the Inspector General
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Strategic Goals
Strategic Goal:
Prevent Crime, Protect the Rights of the American People, and Enforce Federal Law
Statement:
Prevent Crime, Protect the Rights of the American People, and Enforce Federal Law
Strategic Objectives
Statement:
Combat the threat, incidence, and prevalence of violent crime by leveraging strategic partnerships to investigate, arrest, and prosecute violent offenders and illegal firearms traffickers
Description:
Violent crime remains a serious problem in many rural and urban areas and throughout much of Indian Country. It continues to inflict a heavy toll on communities across America, limiting the quality of life for U.S. citizens, paralyzing neighborhoods, and stretching state and local law enforcement resources to their limits.
The vast majority of violent crime in this country falls within the jurisdiction of state and local agencies, and the vast majority of resources to combat it are provided by state and local governments. While some cities are well-equipped to handle issues involving violent gangs, many smaller cities and towns are easily overwhelmed by the violence and criminal activity that gangs bring to their communities. Each community faces different challenges that will require different solutions.
The Department will combat violent crime through vigorous investigation and prosecution of those who engage in violent criminal acts. It will work with its law enforcement partners at the federal, state, local, tribal, and international level to combat all types of violence, from the neighborhood-based street gangs, to increasingly brutal and prevalent violence along the Southwest Border, to the transnational gangs operating throughout the United States and abroad, to violent criminals seeking haven in the United States. It will also employ a comprehensive strategy that focuses on investigation, prosecution, and prevention efforts to address violence in America.
Statement:
Prevent and intervene in crimes against vulnerable populations and uphold the rights of, and improve services to, America’s crime victims
Description:
The Department must continue to be vigilant in supporting and protecting the most vulnerable segments of our population that may fall victim to crime. Children are the most vulnerable and most exploited members of our society. The criminal victimization of children impacts not only the children, but also their families, community, and society at large.
Unfortunately, children are but one segment of society that is at risk. In the United States and across the globe, domestic violence, dating violence, sexual assault, human trafficking, and stalking occur in all ages, races, socioeconomic classes, genders, and sexual orientations. Research shows that these crimes are overwhelmingly committed against women. In addition, elder abuse, neglect, and exploitation is an area that has been overlooked but research suggests it is an ongoing problem in the United States. Further, victims of crime committed on tribal lands is also an area that has been overlooked for far too long as research suggests violent crime rates may be two, four, and in some cases, 10 times the national average.
The Department continues to stress efforts to reduce and respond to violence against vulnerable populations. In April of 2013, the Department issued a revised Sexual Assault Forensic Examination Protocol to standardize up-to-date approaches to victim-centered forensic medical examinations. DOJ will also work with the FBI to support states’ implementation of the revised Uniform Crime Report definition of “rape.” As part of the Attorney General’s Defending Childhood Initiative, the Department will: launch a public awareness and community action campaign to stem youth violence; establish a Task Force on American Indian/Alaska Native Children Exposed to Violence; and partner with select states to form “State Commissions” that will implement model public policy initiatives at the state and local level to reduce the impact of children’s exposure to violence.
All victims deserve to be treated with respect and support. The Department will address the needs of victims by investigating and prosecuting matters impacting vulnerable groups while leading the way in providing innovative training, resources, and support to victims of crime.
Statement:
Disrupt and dismantle major drug trafficking organizations to combat the threat, trafficking, and use of illegal drugs and the diversion of licit drugs
Description:
The Department’s drug strategy will leverage the collective talent and expertise of several federal law enforcement agencies to identify and target drug supply organizations nationwide, to attack their financial infrastructure, and to disrupt and ultimately dismantle them. Through the formation of prosecutor-led, multi-agency task forces that conduct intelligence-driven, multi-jurisdiction investigations, the Department will continue to mount a comprehensive, multilevel, organizational attack on the drug trafficking and money laundering organizations that pose the greatest threat to the Nation. The Department will disrupt and dismantle major drug trafficking organizations responsible for the supply of illegal or diverted drugs in the United States. Additionally, it will use the skills of prosecutors and agents from federal, state, local, and tribal agencies to combat the most prolific drug trafficking and money laundering organizations. Partnerships with state, local, and tribal governments, along with grants and technical assistance will help reduce the use of illegal drugs and the violence associated with that use.
The Southwest Border region is a particularly vulnerable area and has increasingly become a focal point in the national security strategy due to the considerable cross-border law enforcement challenges in the region. The flow of narcotics north into the United States, along with the smuggling of criminal monetary proceeds and the illegal trafficking of firearms south out of the United States has had a devastating effect on the United States and Mexico, particularly along the Southwest Border. Much of the violence along the Southwest Border region and in Mexico is perpetuated by drug trafficking organizations vying for control of trafficking routes to the United States and engaging in turf battles for disputed distribution territories.
The vast 5,225-mile border between the United States and Canada, and the evolving drug trafficking trends on both sides of that border, provide numerous challenges for law enforcement and intelligence entities operating along the Northern border under differing authorities, protocols, and expertise. Marijuana and Ecstasy remain the most significant Northern border drug threats to the United States, while the United States remains the primary transit country for cocaine into Canada from South America.
Statement:
Investigate and prosecute corruption, economic crimes, and transnational organized crime
Description:
The Nation’s recent economic crisis has had significant and devastating effects on mortgage markets, credit markets, and the banking system. The Department will protect Americans from the financial fraud and corruption that devastates consumers, siphons taxpayer dollars, weakens our markets, and impedes our ongoing economic recovery. The impact of financial crime is not confined to Wall Street – and many times the victims of fraud have worked hard and played by established investment rules, only to see their retirement and life savings vanish at the hands of white-collar criminals. Additionally, the rapid expansion of Internet use throughout the Nation, including business and government, creates a continually growing risk of unlawful acts. The Department will focus its white collar enforcement resources on these areas of potential fraud and associated corruption.
These offenses represent separate and very severe threats to the United States’ economy. The corruption of federal, state, and locally elected, appointed, or contracted officials, whether foreign or domestic, undermines democratic institutions and may threaten the condition of the economy, public safety, and national security, while wasting many taxpayer dollars. As businesses, governments, educational institutions, and individual citizens continue to integrate the Internet and other global network computer systems, extortionists, hostile insiders, identity thieves, and other criminals have new opportunities and new venues to commit unlawful acts. The increased presence of fraud such as corporate fraud, securities fraud, healthcare fraud, and mortgage fraud have escalated and will continue to hamper economic recovery and persist long after any recovery occurs. IP crime poses a grave threat to the country’s economic well-being, as well as the health and safety of U.S. citizens. Finally, transnational crime has expanded dramatically in size, scope, and influence, and transnational criminal networks pose a significant threat to national and international security. In response, the Department will implement actions to support the Administration’s Strategy to Combat Transnational Organized Crime, which seeks to build, balance, and integrate the tools of American power to combat transnational organized crime and related threats to national security and urge America’s foreign partners to do the same.
The Department will pursue fraud and corruption committed against the Federal Government and state and local governments and their programs and will protect consumers through vigorous investigations and civil and criminal enforcement of federal laws. These efforts will return significant amounts to the Treasury, Medicare, and other entitlement programs every year and provide deterrence to those contemplating defrauding federal programs, businesses, and individual citizens.
Statement:
Promote and protect American civil rights by preventing and prosecuting discriminatory practices
Description:
The Department is committed to upholding the civil and constitutional rights of all Americans, including the most vulnerable members of society. Federal civil rights statutes reflect some of America’s highest ideals and aspirations – equal treatment and equal justice under law. These statutes not only aim to protect the civil rights of racial and ethnic minorities, but also of members of religious minorities, women, persons with disabilities, service members, individuals housed in public institutions, and individuals who come from other nations and speak other languages. The Department will enforce, defend, and advance civil rights through a multi-faceted approach of litigation, prevention efforts, outreach initiatives, and technical assistance. The Department will work with the Congress, other federal agencies and partnerships, as well as through legislative, regulatory, and policy development. The Department addresses discrimination and promotes equal opportunity in a broad range of areas, including the workplace, schools and higher education institutions, housing, courts, prisons and detention facilities, police departments, and mental health facilities; in voting and immigration-related practices; and in institutions receiving federal financial assistance. The Department also ensures that private institutions of public accommodation comport with applicable federal civil rights laws.
Statement:
Protect the federal fisc and defend the interests of the United States
Description:
The Department of Justice is the Nation’s largest law office and chief litigator. The Department is involved in both defending and representing hundreds of United States’ agencies, offices, and employees; in defending against myriad challenges to federal laws, programs, and policies; and in protecting the integrity of the Nation’s antitrust laws and bankruptcy system. This work is critical to protecting the federal fisc against unwarranted monetary claims and to ensuring the United States can continue to protect the Nation’s security, maintain civil law and order, and ensure public safety. Accordingly, the Department will continue to fulfill these responsibilities by defending the Federal Government against monetary claims and challenges to its jurisdiction and authority, including the constitutionality of statutes passed by Congress.
Defensive litigation impacts virtually every aspect of the Federal Government’s operations. The Department represents over 200 federal agencies, the U.S. Congress, and the federal treasury in litigation arising from a broad range of monetary claims against the government, including legal action related to domestic and foreign operations, American Indian litigation, commercial activities, entitlement programs, internal revenue activities, and environmental and conservation laws. The potential cost to the government and federal tax payers from these matters could be substantial, but through rigorous and fair representation, DOJ will continue to mitigate any potential losses and protect federal monies.
Agency Priority Goals
Statement:
Violent Crime: Protect our Communities by Reducing Gun Violence by using smart prevention and investigative strategies in order to prevent violent acts from occurring.
By September, 30, 2015, the Department of Justice will:
- Increase the number of records submitted to the National Instant Criminal Background Check System (NICS) Index by states and federal agencies by 10%;
- Increase the number of records entered into the National Integrated Ballistic Information Network (NIBIN) by 3%; and
- Increase the number of NIBIN “hits”, that is, the linkage of two or more separate crime scene investigations, based upon comparisons of the markings made on fired ammunition recovered from crime scenes by 3%.
Description:
The Violent Crime Priority Goal supports the Administration’s plan to protect our communities by reducing gun violence with smart prevention and investigative strategies in order to prevent violent acts from occurring. Gun-related violence continues to constitute a serious threat to public safety throughout the United States. While data shows that overall violent crime in the United States has decreased in the past thirty years, many communities continue to experience high levels of gun violence. The Department recognizes that the challenges confronting each community are different and require solutions tailored to each community’s needs. The Department will focus its actions and resources on 1) gun-violence prevention, by effecting an increase in the number of records submitted to NICS Index, which in turn supports the Department’s efforts to accurately and expeditiously identify persons who are legally prohibited from possessing firearms and (2) enhanced and more effective investigation by substantially increasing the number of records entered into NIBIN that contribute to investigative leads. Collectively, accomplishment of these goals will demonstrate and facilitate our progress in preventing and investigating gun-related violent crime.
Statement:
Financial-Healthcare Fraud: Reduce financial and healthcare fraud. By September 30, 2015, the Department of Justice will: reduce by 3 percent the number of financial and healthcare fraud investigations pending longer than 2 years to efficiently and effectively drive those investigations to resolution.
Description:
The recent financial crisis, which has impacted every American, has resulted in fraud and deception in the finance and housing markets as well as fraudulent schemes that misuse the public’s unprecedented investment in economic recovery. Criminals who commit mortgage fraud, securities and commodities fraud, and other types of fraud relating to the response to the economic crisis, victimize the American public as a whole. Similarly, those who defraud Medicare, Medicaid, and other government health care programs defraud every American. In particular, health care fraudsters take critical resources out of our health care system—thus contributing to the rising cost of health care for all Americans and endangering the short-term and long-term solvency of these essential health care programs. The Department will continue to address these critical problems by vigorously investigating and prosecuting both health care fraud and financial fraud, in order to protect American businesses, consumers, and taxpayers.
Statement:
Vulnerable People: Protect vulnerable populations by increasing the number of investigations and litigation matters concerning child exploitation, human trafficking, and non-compliant sex offenders; and by improving programs to prevent victimization, identify victims, and provide services.
By September 30, 2015, working with federal, state, local, and tribal partners, protect potential victims from abuse and exploitation through three sets of key indicators:
- Open investigations concerning non-compliant sex offenders (4% over average of FYs 2012, 2013), sexual exploitation of children (3% over average of FYs 2011, 2012, 2013), and human trafficking (2% over FY 2013).
- Open litigation matters concerning sexual exploitation of children and human trafficking (5% increase over baseline (TBD))
- Percent of children recovered within 72 hours of issuance of an AMBER alert (90%)
Description:
The abuse, neglect, exploitation, and trafficking of children, the elderly, and other vulnerable populations, causes irrevocable harm to victims and society. Ensuring that our children, seniors, and all citizens can live without being disturbed by sexual trauma, physical abuse, or financial exploitation is more than a criminal justice issue; it is a societal and moral imperative. Despite efforts to date, the threat of these crimes remains very real. In the broadest terms, the goal of the Department of Justice (the Department or DOJ) is to prevent child sexual exploitation, elder abuse, and human trafficking from occurring in the first place, in order to protect every person from the physical and mental traumas associated with these crimes.
Strategic Objectives
Strategic Objective:
Investigate and prosecute corruption, economic crimes, and transnational organized crime
Statement:
Investigate and prosecute corruption, economic crimes, and transnational organized crime
Description:
The Nation’s recent economic crisis has had significant and devastating effects on mortgage markets, credit markets, and the banking system. The Department will protect Americans from the financial fraud and corruption that devastates consumers, siphons taxpayer dollars, weakens our markets, and impedes our ongoing economic recovery. The impact of financial crime is not confined to Wall Street – and many times the victims of fraud have worked hard and played by established investment rules, only to see their retirement and life savings vanish at the hands of white-collar criminals. Additionally, the rapid expansion of Internet use throughout the Nation, including business and government, creates a continually growing risk of unlawful acts. The Department will focus its white collar enforcement resources on these areas of potential fraud and associated corruption.
These offenses represent separate and very severe threats to the United States’ economy. The corruption of federal, state, and locally elected, appointed, or contracted officials, whether foreign or domestic, undermines democratic institutions and may threaten the condition of the economy, public safety, and national security, while wasting many taxpayer dollars. As businesses, governments, educational institutions, and individual citizens continue to integrate the Internet and other global network computer systems, extortionists, hostile insiders, identity thieves, and other criminals have new opportunities and new venues to commit unlawful acts. The increased presence of fraud such as corporate fraud, securities fraud, healthcare fraud, and mortgage fraud have escalated and will continue to hamper economic recovery and persist long after any recovery occurs. IP crime poses a grave threat to the country’s economic well-being, as well as the health and safety of U.S. citizens. Finally, transnational crime has expanded dramatically in size, scope, and influence, and transnational criminal networks pose a significant threat to national and international security. In response, the Department will implement actions to support the Administration’s Strategy to Combat Transnational Organized Crime, which seeks to build, balance, and integrate the tools of American power to combat transnational organized crime and related threats to national security and urge America’s foreign partners to do the same.
The Department will pursue fraud and corruption committed against the Federal Government and state and local governments and their programs and will protect consumers through vigorous investigations and civil and criminal enforcement of federal laws. These efforts will return significant amounts to the Treasury, Medicare, and other entitlement programs every year and provide deterrence to those contemplating defrauding federal programs, businesses, and individual citizens.
Agency Priority Goals
Statement: Financial-Healthcare Fraud: Reduce financial and healthcare fraud. By September 30, 2015, the Department of Justice will: reduce by 3 percent the number of financial and healthcare fraud investigations pending longer than 2 years to efficiently and effectively drive those investigations to resolution.
Description: The recent financial crisis, which has impacted every American, has resulted in fraud and deception in the finance and housing markets as well as fraudulent schemes that misuse the public’s unprecedented investment in economic recovery. Criminals who commit mortgage fraud, securities and commodities fraud, and other types of fraud relating to the response to the economic crisis, victimize the American public as a whole. Similarly, those who defraud Medicare, Medicaid, and other government health care programs defraud every American. In particular, health care fraudsters take critical resources out of our health care system—thus contributing to the rising cost of health care for all Americans and endangering the short-term and long-term solvency of these essential health care programs. The Department will continue to address these critical problems by vigorously investigating and prosecuting both health care fraud and financial fraud, in order to protect American businesses, consumers, and taxpayers.
