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Health Care Alert: DOJ Establishes Opioid Fraud and Abuse Detection Unit to Combat Opioid Epidemic

Earlier this month, the Department of Justice (DOJ) announced the creation of a new Opioid Fraud and Abuse Detection Unit. Designed to combat opioid-related health care fraud, the new pilot program will use data analytics to identify and prosecute individuals found to be contributing to the opioid epidemic.

In a speech before the Columbus, Ohio Police Academy, Attorney General Jeff Sessions spoke about the comprehensive approach needed to combat the opioid epidemic. This approach consists of three prongs: prevention, enforcement and treatment. The pilot program intends to focus on prevention and enforcement by targeting the sources of opioids, such as pill mills and pharmacies that divert or dispense prescriptions for unlawful purposes. The unit will employ data analytics to identify suspect prescribers and pharmacies by analyzing providers’ prescription patterns, including the number of prescriptions and the age of the patients for whom the prescriptions are written, the number of patients that die within 60 days of receiving an opioid prescription, and the number of opioid prescriptions that a pharmacy fills.

In addition to using data analytics, the DOJ will fund 12 Assistant United States Attorneys whose sole focus for their three year terms will be investigating and prosecuting opioid-related health care fraud. The prosecutors will work together with the Federal Bureau of Investigation, the Drug Enforcement Agency, the Department of Health and Human Services, and state and local agencies to help target those doctors, medical providers and pharmacies that may be contributing to the opioid epidemic. In his speech, the Attorney General identified the 12 districts which will participate in the program, including the Southern District of Ohio, the Eastern District of Kentucky, the Western District of Pennsylvania, and the Southern District of West Virginia.

The full text of the Attorney General’s speech regarding the Opioid Fraud and Abuse Detection Unit can be accessed here.

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