HHS and DOJ recovered a record $4.1 billion last year!
Kudos to Attorney General Eric Holder and Department of Health and Human Services Secretary Kathleen Sebelius.
Medicare is a core element in our social infrastructure, critically important to all Americans, and one we will ardently and relentlessly defend against the forces of austerity waiting in the wings for 2013. This kind of good news proves Medicare can, and is, effectively managed which deserves recognition. Hopefully even more can be done in 2012.
Today the Obama administration plans to announce that effort to combat Medicare fraud were successful last year. WaPo
Federal authorities say they recovered $4.1 billion in health care fraud judgments last year, a record high which officials on Monday credited to new tools for cracking down on deceitful Medicare claims.
The recovered funds are up roughly 50 percent from 2009. Attorney General Eric Holder and Department of Health and Human Services Secretary Kathleen Sebelius were expected to make the announcement at a news conference Tuesday.
...agencies are doing a better job of screening providers before they get in the system and have beefed up enrollment requirements. Now investigators are conducting site visits to make sure moderate risk providers have a legitimate office. Higher risk providers are also subject to fingerprint and criminal background checks.
Authorities have long said the solution to solving the nation’s estimated $60 billion to $90 billion a year Medicare fraud problem lies in vigorously screening providers and stopping payment to suspicious ones.
Medicare fraud is estimated to cost Americans from $60 million to $90 million a year and is perennially identified on
GAO's hit list for government waste, fraud, and abuse. One of the ways the Obama administration responded was by forming strike teams in hot spots around the country including including South Florida, Detroit and Los Angeles.
2010 Medicare Fraud Strike Task Force Charges
In July 2010, the Medicare Fraud Strike Task Force announced its largest fraud discovery ever when charging 94 people nationwide for allegedly submitting a total of $251 million in fraudulent Medicare claims. The 94 people charged included doctors, medical assistants, and health care firm owners, and 36 of them have been found and arrested.[20][21] Charges were filed in Baton Rouge (31 defendants charged), Miami (24 charged) Brooklyn, (21 charged), Detroit (11 charged) and Houston (four charged).[20] By value, nearly half of the false claims were made in Miami-Dade County, Florida.[21] The Medicare claims covered HIV treatment, medical equipment, physical therapy and other unnecessary services or items, or those not provided.[22]
2011 Medicare Fraud Strike Task Force Charges
In September 2011, a nationwide takedown by Medicare Fraud Strike Force operations in eight cities resulted in charges against 91 defendants for their alleged participation in Medicare fraud schemes involving approximately $295 million in false billing.[23]
And in today's
LAT
LA businessman gets 8 years for Medicare fraud
The co-owner of two Los Angeles-area health care companies has been sentenced to eight years in prison for scheming to defraud Medicare out of millions.
Federal prosecutors said in a statement that 49-year-old Evans Oniha was also sentenced Monday to three years of supervised release after prison and $7 million in restitution.
A jury in July convicted Oniha of one count of conspiracy to commit health care fraud, four counts of health care fraud and one count of false statements relating to health care.
Prosecutors said that for nine years Oniha wrongly obtained Medicare beneficiary information and used it to submit false claims for equipment and home health services.
This 2010 document explains strategies for identifying Medicare fraud -
MEDICARE FRAUD, WASTE, AND ABUSE, Challenges and Strategies for Preventing Improper Payments.
False or falsified billing claims and inappropriate clinical and procedure codes are common forms of fraud. Beneficiaries can help by reviewing bills and this document explains how to Report Medicare Fraud.