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HHS and DOJ expand health care fraud ‘strike force’

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Government's top health and law enforcement officials are meeting today with insurance regulators and other public and private entities to strategize ways to put the brakes on health care fraud.

U.S. health care fraud occurs so often and is so widespread that 10 cents of every dollar spent on health care goes toward paying for fraudulent claims, according to the Legal Information Institute at Cornell University. At least 3 percent of all U.S. health care spending, representing $68 billion, is lost to health care fraud. The National Health Care Anti-Fraud Association says what the U.S. spends on fraudulent claims each year exceeds most countries’ GDP.

Perpetrators of health care fraud are “criminals” who must be stopped, said Health and Human Services Secretary Kathleen Sebelius who, along with Attorney General Eric Holder, is hosting a fraud prevention summit today in Washington, D.C.

Closing plenary remarks can be watched via webcast from 3 to 4 p.m. ET at StopMedicareFraud.gov.

Sebelius and Holder picked up the fraud prevention mantle in May 2009 by creating “Strike Force Teams” to investigate and prosecute fraud cases. HHS claims that more than 500 individuals and organizations have been indicted for bilking the federal Medicare program out of $1 billion since the effort began. Fraud prevention efforts are currently underway in Miami and Tampa, Fla., Los Angeles, Detroit, Houston, Brooklyn, N.Y. and Baton Rouge, La.

“Health care fraud isn’t just a government problem. Criminals don’t discriminate and they are stealing from Medicare, Medicaid and private companies at an unacceptable rate,” said Sebelius. “We have a shared interest in stopping these crimes and today’s summit brought us together to discuss how we can all work together to fight fraud.”

Sebelius said President Obama’s FY 2011 budget being unveiled next week will include support for anti-fraud efforts that could save billions over the next 10 years. “He will call for increased investments in programs that have a proven record of preventing fraud, reducing payment errors and returning funds to the Trust Funds,” she said.

Workgroups are focusing on use of technology to prevent and detect health care fraud and improper payments, the role of states in preventing health care fraud, fraud prevention policies, law enforcement strategies, and health care fraud analysis and reporting.

“Health care fraud affects all Americans and demands a coordinated, national response,” said Holder.

Results of the summit will be made available to the public, according to HHS.

For more:

Health care fraud: an overview – Cornell University Law School

The National Health Care Anti-Fraud Association (NHCAA) 

Subscribe to comments feed Comments (9 posted):

ann on 01/28/2010 10:57:02
do you think if we had Universal Health care, Single Payer this wouldn't be able to happen? or bbe less likely to happen?
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cheap r4 dsi on 02/03/2010 00:40:20
Health care fraud is indeed getting quite rampant now days. It is good to have some organization devoted to prevent such fraudulent activities
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Michael on 02/06/2010 14:50:26
If the figure of ten cents out of every dollar is true this is indeed a major issue.

If it's any comfort to American readers, the same thing is happening here in France.

The perpetrators deserve stiff sentences.
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16gb micro sd card on 02/17/2010 01:53:20
Hi Guy's,
It is good to have some organization devoted to prevent such fraudulent activities
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personal injury Houston on 05/27/2010 01:40:30
The case of such fraudulent incidents with innocent people are increasing.The case was brought as part of the Medicare Fraud Strike Force which was supervised by the Criminal Division's Fraud Section and the U.S. Attorney's Office for the Central District of California.
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antiinflamatorios on 06/02/2010 15:39:13
Quote from the StopMedicareFraud site:
* A health care provider bills Medicare for services you never got.
* A supplier bills Medicare for equipment you never got.
* Someone uses another person’s Medicare card to get medical care, supplies, or equipment.
* Someone bills Medicare for home medical equipment after it has been returned.
* A company offers a Medicare drug plan that hasn’t been approved by Medicare.
* A company uses false information to mislead you into joining a Medicare plan.
So it seems that it's predominantly health care providers and busu=inesses that commit the fraud.
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wrongful death case on 06/24/2010 02:00:24
I was just reading this a while ago: "The Obama administration is focused on reducing all improper payments in federal programs, whether the result of criminal intent, greed or inefficiencies. So the Fiscal Year (FY) 2011 Budget Request to the Congress covers all types of fraud and abuse, as well as other categories of improper payments. With this funding request, we will be adding resources to law enforcement and program oversight, as well as to program integrity operations in the Centers for Medicare & Medicaid Services (CMS)." Read more at http://www.hhs.gov/asl/testify/2010/03/t20100304a.html
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logo design on 06/30/2010 05:08:48
thanks for your post.
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LawLeaf on 03/01/2011 00:22:49
Health care fraud is out of control. Regardless of what the system, HCF will continue.
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