Feds Recover $5.6 Billion in Fraud

$2.9 Billion of Total Was Healthcare Fraud
Feds Recover $5.6 Billion in Fraud
The Justice Department reports that it has recovered more than $5.6 billion in fraud this year, including $2.9 billion in healthcare fraud. The total fraud recovery is up 167 percent since 2008.

In announcing the fraud figures Dec. 13, Vice President Joe Biden and Deputy Attorney General James Cole noted:

  • Fraud recoveries this year included almost $3.4 billion in civil fraud and $2.2 billion in criminal fraud.
  • Of the $15 billion in total fraud recovered since 2009, $8.4 billion was in healthcare.
  • Healthcare fraud recovery stems, in part, from expanded use of Medicare Fraud Strike Forces, specialized teams of agents and prosecutors. The teams monitor Medicare data in real time. Strike force teams are now in place in nine cities, up from two in 2009.
  • Governmentwide improper payment rates, including fraudulent payments and other types of errors, were cut 11 percent this year, avoiding $18 billion in inappropriate payments.

Meanwhile, the Department of Health and Human Services has announced a new effort to crack down on Medicare fraud involving painkillers and narcotics that are abused or resold. HHS has asked all Medicare prescription drug plans to withhold payment on suspicious claims, including when enrollees use multiple physicians to obtain painkillers and narcotics, until they verify the claims are valid. The Government Accountability Office recently reported that 170,000 Medicare beneficiaries received prescriptions from five or more physicians for frequently abused drugs.

The Centers for Medicare and Medicaid Services' website has more information on healthcare fraud-fighting efforts.

About the Author

Howard Anderson

Howard Anderson

News Editor, ISMG

Anderson is news editor of Information Security Media Group and was founding editor of HealthcareInfoSecurity and DataBreachToday. He has more than 40 years of journalism experience, with a focus on healthcare information technology issues. Before launching HealthcareInfoSecurity, he served as founding editor of Health Data Management magazine, where he worked for 17 years, and he served in leadership roles at several other healthcare magazines and newspapers.

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