Healthcare Fraud Prevention and Enforcement Efforts Result In Record-Breaking Recoveries Totaling Nearly $4.1 Billion

Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius released a new report showing that the government’s healthcare fraud prevention and enforcement efforts recovered nearly $4.1 billion in taxpayer dollars in fiscal year (FY) 2011. This is the highest annual amount ever recovered from individuals and companies who attempted to defraud seniors and taxpayers or who sought payments to which they were not entitled. These findings are a result of President Obama making the elimination of fraud, waste, and abuse a top priority in his administration. These efforts to reduce fraud will continue to improve with the new tools and resources provided by the Affordable Care Act, including an additional $350 million for HCFAC activities. The administration is already using tools authorized by the Affordable Care Act, including enhanced screenings and enrollment requirements, increased data-sharing across government, expanded overpayment recovery efforts, and greater oversight of private insurance abuses. The departments also continued their successes in civil healthcare fraud enforcement during FY2011. Approximately $2.4 billion was recovered through civil healthcare fraud cases brought under the False Claims Act (FCA). These matters included Medicare fraud by hospitals and other institutional providers, and violations of laws against self-referrals and kickbacks.