Medicare anti-fraud efforts net $2.5 billion

Funding from the economic stimulus package was used to recoup losses for Medicare, boost criminal probes and provide new tools to law enforcement, HHS says.

By Chris Silva — Posted May 27, 2010

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The passage of the economic stimulus bill last year gave the government more resources to protect consumers and safeguard taxpayer dollars, and the investment already is paying dividends, according to Health and Human Services Secretary Kathleen Sebelius.

HHS and the Justice Dept. released its annual health care fraud and abuse report on May 13. It showed that in fiscal 2009, anti-fraud efforts resulted in $2.51 billion being returned to the Medicare trust fund, a $569 million, or 29%, increase over fiscal 2008. In addition, more than $441 million in federal Medicaid money was returned to the Dept. of the Treasury through anti-fraud and abuse efforts, a 28% increase from fiscal 2008, HHS and Justice said.

Sebelius said an additional $600 million over 10 years will be allocated for anti-fraud initiatives.

"We're going to provide new resources to get more boots on the ground to fight fraud in communities across the country," Sebelius said. "We're going to make it easier for law enforcement to see health care claims data from different government agencies in one place. Under the old system, it was as if police officers in one town weren't talking to the officers in the next town over."

Sebelius and U.S. Attorney General Eric Holder also highlighted the progress made by their joint program, the Health Care Fraud Prevention and Enforcement Action Team, which has operations in Baton Rouge, La.; Brooklyn, N.Y.; Detroit; Houston; Los Angeles; Miami; and Tampa, Fla.

The two departments in January hosted the first-ever National Health Care Fraud Summit, where they discussed new reforms to improve information-sharing, ways to spot fraud trends, and actions to increase sanctions and penalties.

The annual fraud and abuse report is available online (link).

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