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Mon Feb 11, 2013, 09:18 PM

Medicare Fraud: HHS announces record-breaking $4.2 Billion recovered in FY 2012

Departments of Justice and Health and Human Services announce record-breaking recoveries resulting from joint efforts to combat health care fraud

Government Teams Recovered $4.2 Billion in FY 2012

WASHINGTON – Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius today released a new report showing that for every dollar spent on health care-related fraud and abuse investigations in the last three years, the government recovered $7.90. This is the highest three-year average return on investment in the 16-year history of the Health Care Fraud and Abuse (HCFAC) Program.

The government’s health care fraud prevention and enforcement efforts recovered a record $4.2 billion in taxpayer dollars in Fiscal Year (FY) 2012, up from nearly $4.1 billion in FY 2011, from individuals and companies who attempted to defraud federal health programs serving seniors and taxpayers or who sought payments to which they were not entitled. Over the last four years, the administration’s enforcement efforts have recovered $14.9 billion, up from $6.7 billion over the prior four-year period. Since 1997, the HCFAC Program has returned more than $23 billion to the Medicare Trust Funds.

These findings, released today in the annual HCFAC Program report, are a result of President Obama making the elimination of fraud, waste and abuse, particularly in health care, a top priority for the administration.

The success of this joint Department of Justice and HHS effort was made possible by the Health Care Fraud Prevention and Enforcement Action Team (HEAT), created in 2009 to prevent fraud, waste and abuse in the Medicare and Medicaid programs and to crack down on individuals and entities that are abusing the system and costing American taxpayers billions of dollars. These efforts to reduce fraud will continue to improve with new tools and resources provided by the Affordable Care Act.

“This was a record-breaking year for the Departments of Justice and Health and Human Services in our collaborative effort to crack down on health care fraud and protect valuable taxpayer dollars,” said Attorney General Holder. “In the past fiscal year, our relentless pursuit of health care fraud resulted in the disruption of an array of sophisticated fraud schemes and the recovery of more taxpayer dollars than ever before. This report demonstrates our serious commitment to prosecuting health care fraud and safeguarding our world-class health care programs from abuse.”

“Our historic effort to take on the criminals who steal from Medicare and Medicaid is paying off: We are gaining the upper hand in our fight against health care fraud,” said Secretary Sebelius. “This fight against fraud strengthens the integrity of our health care programs and helps us fulfill our commitment to our seniors.”

About $4.2 billion stolen or otherwise improperly obtained from federal health care programs was recovered and returned to the Medicare Trust Funds, the Treasury and others in FY 2012. This is an unprecedented achievement for the HCFAC Program, a joint Justice Department and HHS effort to coordinate federal, state and local law enforcement activities to fight health care fraud and abuse.

The administration is also using tools authorized by the Affordable Care Act to fight fraud, including enhanced screenings and enrollment requirements, increased data sharing across the government, expanded recovery efforts for overpayments and greater oversight of private insurance abuses.

- more -

http://www.hhs.gov/news/press/2013pres/02/20130211a.html


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Response to ProSense (Original post)

Mon Feb 11, 2013, 09:21 PM

1. K&R

but some will see this as cutting health care for the poor. here. not over in teap land, but here.

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Response to ProSense (Original post)

Mon Feb 11, 2013, 09:40 PM

2. RW to start shrieking about these horrible cuts to Medicare in 3....2....1....

Cuts in theft, that is.

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Response to ProSense (Original post)

Mon Feb 11, 2013, 09:51 PM

3. People that want to cut benefits to Medicare and

Social Security............

I wish I could wave a magic wand and make those people understand that it is not the people maintaining their health that is a drain on the Medicare program - it is the wealthy, European car-driving, yacht-owning, penthouse having Medicare cheats (mostly doctors and medical provider groups) that are draining Medicare plan.

These people often cheat Medicare of millions, sometimes tens of millions of dollars, dollars that could be used to provide care hundreds or thousands of Americans. These people are the real villains, of our healthcare system, and not the sick people who use the benefits.

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Response to TheDebbieDee (Reply #3)

Mon Feb 11, 2013, 10:40 PM

4. That AND we do have VERY expensive end of life care in the USA

Many people die in ICUs on lots of drips ventilators and machines from illnesses that are not treatable in end stage. This didn't happen as much decades ago and it's not happening in a lot of the single payer countries:

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Response to ProSense (Original post)

Mon Feb 11, 2013, 10:55 PM

5. THAT'S the kind of Medicare reform we needed! And we are getting it

Can we all agree that cutting fraud and waste and abuse means there is a lot more money to go around for actual health care? And that this is indeed Reform?

I knew we could.

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Response to ProSense (Original post)

Mon Feb 11, 2013, 11:16 PM

6. Yes but the media will ignore this and the GOP will call it cuts to Medicare. nt

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Response to kelliekat44 (Reply #6)

Mon Feb 11, 2013, 11:34 PM

7. Yes, and on and on the Stupid

burns.

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Response to ProSense (Original post)

Mon Feb 11, 2013, 11:49 PM

8. And for every dollar spent investigating bankster criminal fraud, we... oh wait. Forget that. n/t

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Response to ProSense (Original post)

Mon Feb 11, 2013, 11:52 PM

9. Actrually it is a good thing. Even if it is just 10% of the amount we are paying for mortgage-

backed assets for the wealthy to prop up their financing of properties. Every month. So the rich don't lose money. Because that is good for the rest of us.

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Response to ProSense (Original post)

Mon Feb 11, 2013, 11:53 PM

10. Sadly, a CEO whose company was involved in such fraud is now a state governor.

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