Health Care Industry

USABulletin April 1997 Volume 45, Number 2 Health Care Fraud Issues In This Issue Interview with United States Attorney Lynne A. Battaglia, District of Maryland Health Care Fraud Legislation Operation LABSCAM The Tao of the Health Care Fraud Trial A Basic Remedy for a Health Care Fraud Headache Published by Executive Office for United States Attorneys Washington, D.C. Carol DiBattiste, Director United States Attorneys’ Bulletin Staff, (202) 616-1681 David Marshall Nissman, Editor-in-Chief Wanda J. Morat, Editor Barbara J. Jackson, Editor Patrice A. Floria, Editor Susan Dye Bartley, Graphic Designer Nina M. Ingram, Student Assistant Send distribution address and quantity corrections to: Barbara Jackson, Executive Office for United States Attorneys, Bicentennial Building, Room 6011, 600 E Street, N.W., Washington, D.C. 20530-0001 (202) 616-8407 or fax (202) 616-6653 From the Editor-in-Chief For those engaged in the enforcement of the law, life is a constant series of herculean ascents up changing mountain tops. When America began to be confronted with multi-national drug cartels, we developed a series of laws, and the expertise to dismantle organizations and to seize their assets. When we were confronted with the Savings and Loan crisis, we quickly marshaled the energy and proficiency to react to that threat. One of the great challenges to our way of life today is the vast amount of health care fraud and abuse. The next two issues of the United States Attorneys’ Bulletin are dedicated to exploring many of the issues found in health care fraud cases. Perhaps in this area of our practice more than any other, we are forced to bring the civil and criminal sides of our house together to discuss meaningful strategies and opportunities for successful prosecutions. This is reflected in the nature of our contributing authors who come from both civil and criminal backgrounds. We are sure that you will join us in thanking them for their tremendous dedication to our common mission. By sharing our collective expertise with each other, we help advance the quality of our representation in the courts of the United States. To those of you who feel you can help your colleagues with other techniques you have developed in health care fraud cases, please feel free to send them to us for inclusion in the next issue. On the inside back cover of the magazine is our publication schedule for the next six months. We are looking for a volunteer to catalog the various investigative database capabilities of the Federal investigative community. During USABook training, Assistant United States Attorneys in many of the west coast United States Attorneys’ offices requested a USAB devoted to this subject, and we are determined to respond. Earlier we mentioned that this publication is only as good as the quality of the contributing authors. Congratulations to all of you as both the quality and quantity of your submissions continue to spiral upward. David Marshall Nissman Contents Interview with United States Attorney Lynne A. Battaglia, District of Maryland Tips for Parallel Civil and Criminal Proceedings Who’s Who at DOJ in Health Care Fraud EOUSA Health Care Fraud Resources Fact Sheet Health Care Fraud Legislation Multi-district Investigation and Prosecution of Medicare Fraud: The Benefits of Taking the Team Approach Operation LABSCAM The Tao of the Health Care Fraud Trial Practicing in the Field of Injunctions A Basic Remedy for a Health Care Fraud Headache The Federal False Claims Act as a Remedy to Poor Care Determining “Loss” in Medicare Fraud Prosecutions Enforcement of HHS Inspector General Subpoenas and Authorized Investigative Demands Going the Long Way: Investigating Fraud Without Computerized Records Attorney General Highlights Anti-Gang and Youth Violence Strategy OCDETF Regional Reorganization President Clinton Seeks to Reclaim Communications Frequencies United States Attorneys’ Offices/Executive Office for United States Attorneys United States Attorney Temporary Relocation Significant Issues/Events EOUSA Staff Update Office of Legal Education Computer Tips DOJ Highlights Civil Division Civil Rights Division Criminal Division Office of the Solicitor General Office of Inspector General Office of Justice Programs Immigration and Naturalization Service Ethics and Professional Responsibility Grand Jury—Attempt to Improperly Influence Grand Jury—Statement that Witness Would Commit Perjury Grand Jury—Characterization of Evidence—Calling of Witnesses Career Opportunities Districts of Guam and the Northern Mariana Islands, Saipan Office—Assistant United States Attorney Civil Division, Commercial Litigation Branch—GS-12 to GS-15 Experienced Attorneys Criminal Division, Narcotic and Dangerous Drug Section—GS-15 Experienced Attorney Criminal Division, Organized Crime and Racketeering Section—GS-12 to GS-15 Experienced Attorney Criminal Division, Terrorism and Violent Crime Section—GS-13 to GS-15 Experienced Attorneys Tax Division, Civil, Criminal, and Appellate Sections—GS-11 to GS-13 Experienced Attorneys Office of the Pardon Attorney—GS-12 to GS-15 Experienced Attorneys Appendix A—AGAC Subcommittees Appendix B—Professional Responsibility Officers Appendix C—Security Tips Appendix D—OLE Course Nomination Form Appendix E—Videotapes Available for Formal and Informal Showings Interview with United States Attorney Lynne Battaglia, District of Maryland At the time of this interview, United States Attorney Lynne Battaglia was Chair of the AGAC Health Care Fraud Subcommittee. She served as Chair from the Subcommittee’s inception three years ago to the end of March 1997. (The current Chair of the Health Care Fraud Subcommittee is United States Attorney Don Nickerson, Southern District of Iowa.) Ms. Battaglia became the United States Attorney for the District of Maryland in August 1993. Her academic background includes undergraduate and Master’s degrees from American University, and a Juris Doctor degree from the University of Maryland Law School. From 1974 to 1978, she served as an associate attorney at the Baltimore law firm of Semmes, Bowen & Semmes. From 1978 to 1982 she served as an Assistant United States Attorney for the District of Maryland, where she prosecuted numerous cases involving bank robbery, mail fraud, drug violations, and tax evasion, and served as the civil case liaison for the United States Attorney. In 1983, she became Visiting Professor of Law at the University of Maryland Law School, where she taught courses in the Clinical Law Program, and on Women and the Law. In 1984, Ms. Battaglia became Senior Trial Attorney for the Department’s Office of Special Litigation, where she tried complex tax shelter cases throughout the United States. In 1988, Maryland Attorney General J. Joseph Curran selected Ms. Battaglia as the Chief of the Criminal Investigations Division where she supervised attorneys, accountants, and investigators involved in prosecuting white collar and environmental crimes. Within three years, she became the Chief of Staff to United States Senator Barbara A. Mikulski, where she supervised the work of the Washington office, two subcommittees, and six state offices, in addition to serving as Legal Advisor to Senator Mikulski’s office. From September 1994 to October 1995, Ms. Battaglia served as Vice-Chair of the Attorney General's Advisory Committee (AGAC) and, in addition to serving as Chair of the Health Care Fraud Subcommittee, she is active in other AGAC subcommittees, including Environmental Crimes and Civil Rights. United States Attorney Lynne Battaglia (LB) was interviewed by Assistant United States Attorney Lee Wiedman (LW), Central District of California. LW: Prior to becoming United States Attorney, you had a comprehensive career. You worked in private practice, you were an Assistant United States Attorney, and you were a trial attorney in the Department. Despite that broad experience, have you encountered any unique situations since becoming the United States Attorney for the District of Maryland? LB: I’ve found that the work of the United States Attorney in this administration under Janet Reno is more extensive than my experience with United States Attorneys in prior administrations. We’re called upon to deal with more local police forces. We have done much more community outreach to let individuals know that there is a United States Attorney’s office and that we can do things in the community that, in the past, we have not been able to, and we look forward to doing those things. Additionally, the explosion in statutory law in the last two decades has transformed United States Attorneys’ offices as well. LW: You’ve been a member of the Attorney General’s Advisory Committee (AGAC); in fact, you were Vice Chair of the AGAC in 1993. Could you tell us how the AGAC is structured and what its functions are? LB: The AGAC is a group of United States Attorneys that is chosen by the Attorney General to advise her on matters that affect all of the United States Attorneys’ offices as well as the Department. The group functions through subcommittees, such as the Health Care Fraud Subcommittee, of which I’ve been fortunate enough to be the Chair for more than three years. The subcommittees take up issues that confront the United States Attorneys and the Department nationwide, as well as locally, and develop suggestions for the AGAC and then the Attorney General on handling issues or resolving crises. LW: Health care fraud has been the Department’s number one white collar crime priority since 1993. What have been the Department’s most significant accomplishments in the area of health care fraud over the last four years? LB: One of the greatest accomplishments has been the recognition of the importance of health care fraud in the United States. Until Janet Reno became the Attorney General, I do not think we had an appreciation of the extent to which health care fraud has impacted the Medicare system; the entire issue concerning portability of health care plans with people from place to place; or the impact of managed care on the health care industry.

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