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The Health Care Fraud Unit oversees investigations targeting individuals and/or organizations who are defrauding the public and private health care systems.
Areas investigated under health care fraud include: billing for services not rendered, billing for a higher reimbursable service than performed (upcoding), performing unnecessary services, kickbacks, unbundling of tests and services to generate higher fees, durable medical equipment fraud, pharmaceutical drug diversion, outpatient surgery fraud, and internet pharmacy sales.
In addition, the Financial Crimes Enforcement Network and Dunn & Bradstreet have been able to provide significant background information on subject individuals or subject companies in an investigation.
Through Fiscal Year 2005, cases pursued by the FBI resulted in 497 indictments and 317 convictions of corporate criminals.
It is anticipated that the number of cases will continue to flourish. It remains the #1 priority within the Financial Crimes Section.
There are presently 405 Corporate Fraud cases being pursued by FBI field offices throughout the United States.
Through the manipulation of financial data, the share price of a corporation remains artificially inflated based on fictitious performance indicators provided to the investing public.
The majority of corporate fraud cases pursued by the FBI involve accounting schemes designed to deceive investors and Wall Street analysts about the true financial condition of a corporation.
The FBI has worked with numerous organizations in the private industry to increase public awareness about combating corporate fraud, to include: Public Company Accounting Oversight Board, American Institute of Certified Public Accountants and the North American Securities Administrator’s Association, Inc.