Federal Manager's Daily Report

The Departments of Justice and Health and Human Services have announced joint efforts to combat healthcare fraud resulted in the recovery of $4.3 billion in fiscal 2013 and $19.2 billion over the past five years. In an annual Health Care Fraud and Abuse Control program report, they say that every dollar spent on recovery in the past three years netted $8.10.

The departments credited higher enforcement returns in recent yearswith the formation of a Health Care Fraud Prevention and Enforcement Action Team in 2009. (Enforcement successes should be qualified: The Centers for Medicare and Medicaid Services has reported that $49.9 billion in Medicare payments in 2013 can be considered improper.)

Said HHS Secretary Sebelius,”New enrollment screening techniques are proving effective in preventing high risk providers from getting into the system, and the new computer analytics system that detects and stops fraudulent billing before money ever goes out the door is accomplishing positive results – all of which are adding to savings for the Medicare Trust Fund.”