The Fight Against Fraud In The US Health Care System

The Fight Against Fraud In The US Health Care System.
The Department of Justice secured $3 billion in civilian settlements and judgments in cases involving cheating against the regulation in the fiscal year ending Sept 30, 2010, Tony West, Assistant Attorney General for the Civil Division, announced today. This includes $2,5 billion in salubriousness anxiety fraud recoveries-the largest in history-and represents the jiffy largest annual recovery of civil fraud claims. Moreover, amounts recovered under the False Claims Act since January 2009 have eclipsed any above-mentioned two-year period with $5,4 billion in taxpayer dollars returned to federal programs and the Treasury.

Recoveries since 1986, when Congress basically strengthened the public False Claims Act, now total more than $27 billion. "Under Attorney General Eric Holder's leadership, our hostile pursuit of fraud under the False Claims Act has resulted in the largest two-year advancement of taxpayer dollars in the history of the Justice Department," Assistant Attorney General West said. "Nowhere is this more obvious than in our success in fighting health charge fraud. Since January 2009, the Civil Division, together with the US Attorneys' offices, commenced more fettle care fraud investigations, secured larger fines and judgments, and recovered more taxpayer dollars bewildered to health care fraud than in any other two-year period".

Fighting fraud committed against viewable health care programs is a top priority for the Obama Administration. On May 20, 2009, Attorney General Eric Holder and Kathleen Sebelius, Secretary of the Department of Health and Human Services (HHS), announced the making of a unique interagency task force, the Health Care Fraud Prevention and Enforcement Action Team (HEAT), to gain coordination and optimize hood and civil enforcement. These efforts not only protect the Medicare Trust Fund for seniors and the Medicaid program for the country's neediest citizens, they also outcome in higher quality form care at a more reasonable price.

The record health care fraud civil recoveries of $2,5 billion announced today made up 83 percent of the year's complete civil artifice recoveries. HHS reaped the biggest recoveries, largely attributable to its Medicare and Medicaid programs. Recoveries were also made by the Office of Personnel Management, which administers the Federal Employees Health Benefits Program, the Department of Defense for its TRICARE indemnification program and the Department of Veterans Affairs, to each others.

Assistant Attorney General West notorious that since January 2009, the Civil Division, together with the US Attorneys' offices, set a two-year document for health care fraud enforcement efforts, recovering $4,6 billion in taxpayer funds under the False Claims Act from healthiness carefulness providers and others in the industry, and securing 25 criminal convictions as well as more than $3 billion in fines, forfeitures, reinstatement and disgorgement under the Food, Drug and Cosmetic Act (FDCA).

The False Claims Act cases successfully resolved this year not only included pay schemes implicating federal vigour care programs, but also wartime and other government procurement contracts; grants for small businesses, bullet-proof vests for inference enforcement, and other purposes; federally insured mortgages; federal and Indian mineral leases; and many other federal programs. Assistant Attorney General West commended the sound efforts of the Civil Division's trade attorneys, the US Attorneys' Offices, and the federal and magnificence agencies that investigate and support False Claims Act prosecutions, remarking that "their consecration and the cooperation we enjoy allow us to bring all of our resources to bear in combating fraud against both the federal and confirm governments".

Most of the cases resulting in recoveries were brought to the government by whistleblowers under the False Claims Act, the federal government's pre-eminent weapon in the battle against fraud. In 1986, Senator Charles Grassley and Representative Howard Berman led prosperous efforts in Congress to amend the False Claims Act to correct the statute's qui tam (or whistleblower) provisions, which boost whistleblowers to come forward with allegations of fraud. Assistant Attorney General West paid excise to the 1986 amendments' sponsors, saying: "Without their foresight, these recoveries would not have been possible". He also expressed his gratefulness to Senator Patrick J Leahy, Chairman of the Senate's Judiciary Committee, and to Senator Grassley and Representative Berman for their undergo of the Fraud Enforcement and Recovery Act of 2009, which made additional improvements to the False Claims Act and other dodge statutes.