Justice Department and HHS Recover $4.2 Billion of Health Care Fraud in 2012

Health care fraud has been on the rise in the last three years, even more so in 2012 than others, according to a report released today by the Departments of Justice (DOJ) and Health and Human Services (HHS). 

Recovering a record-breaking amount of taxpayers’ dollars from health care-related fraud, DOJ and HHS returned $4.2 billion to the Medicare Trust Funds in Fiscal Year 2012 alone. 

In the report by Attorney General Eric Holder and HHS Secretary Kathleen Sebelius, the government teams found that for every dollar spent on health care fraud in the last three years, the agencies recovered $7.90—the highest three-year average return on investment in the 16 years since the Health Care Fraud and Abuse (HCFAC) Program was established. 

In collaboration with the Health Care Fraud Prevention and Enforcement Team (HEAT), DOJ’s and HHS’s recovery in 2012 was up from the $4.1 billion the agencies reported in 2011. 

Since its inception in 2009, HEAT has been dedicated to sniffing out health care fraud among individuals and entities abusing the health care system, and ultimately, costing taxpayers billion of dollars. 

“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 recover of more taxpayer dollars than ever before,” said Attorney General Holder. 

The $4.2 billion was returned to the Medicare Trust Funds, the Treasury and other in FY 2012, the report notes. 

“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 out integrity of our health care programs and helps us fulfill our commitment to our seniors.”

In FY 2012, the DOJ opened 1,131 new criminal health care fraud investigations, resulting in the convictions of 826 defendants.

Written by Jason Oliva