Tuesday, February 16, 2010

Anticipate More Health Care Fraud Cases

In a recent speech by AG Holder he recapped this year's health care fraud prosecutions and predicted that more would be coming. (see press release) Holder was speaking at the National Summit on Health Care Fraud.  He said that:

"last year brought record levels of achievement in our fight against health care fraud. In 2009, the Justice Department reached an all-time high in the number of health care fraud defendants charged, more than 800. We also obtained more than 580 convictions. And on the civil enforcement front, our health care fraud recoveries last year under the False Claims Act exceeded a stunning $2.2 billion dollars."

He spoke of five things that would be happening to combat health care fraud.  One of them was:

"we must strengthen HEAT. We will continue to combine and leverage our agencies’ resources and expertise, including the FBI and the Office of Inspector General at HHS, to prevent and prosecute fraud. HEAT will continue to work closely with local U.S. Attorneys Offices to pursue both civil and criminal cases. And in bringing these fraudsters to justice, we will use the power of the Internet and the media to inform the public and the health care industry about how to prevent future fraud schemes."

And just looking at this past month, one finds the emphasis on health care matters.  See DOJ Press Release,  Former Los Angeles Medical Center Owners Agree to $10 Million Consent Judgment for Medicare and Medi-Cal Fraud Scheme; DOJ Press Release, Jury Convicts Detroit Area Doctor of Health Care Fraud Conspiracy

(esp)

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Comments

DHHS-CMS could make a dramatic reduction is fraud cases in durable medical equipment by simply determining there is actually a DME company doing business.

Many of the DME fraud cases are committed by criminals who were never even in the business (which begs the question how they received a Medicare billing number).

Posted by: save_the_rustbelt | Feb 16, 2010 1:41:40 PM

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