Government
Whistle-blower activity on the rise for health care fraud
NEWS IN BRIEF — Posted Oct. 6, 2008
Increased efforts by the U.S. Dept. of Justice to combat health care fraud were accompanied by an uptick in whistle-blower actions, according to a recent study documenting a decade of Medicare and Medicaid fraud cases.
The government closed 379 cases that recovered $9.3 billion between 1996 and 2005, said the report, published in the September Annals of Internal Medicine.
By 2005, 90% of new actions were initiated by whistle-blowers, who each received an average of $3.6 million.
Whistle-blowers were most commonly health care executives and physicians, while the most common targets of accusations were hospitals and physician practices.
Billing fraud, particularly for unnecessary medical services, was the top alleged violation.
Although pharmaceutical manufacturers were defendants in only 4% of fraud cases over the decade, they accounted for 39%, or $3.6 billion, of total judgments and settlements.
Note: This item originally appeared at http://www.ama-assn.org/amednews/2008/10/06/gvbf1006.htm.
