Medicare fraud

WEDNESDAY, AUGUST 31, 2011

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The Obama administration is cracking down on health care fraud that can drive up costs and subject patients to medically unnecessary testing.

Data compiled by the Transactional Records Access Clearinghouse at Syracuse University show 903 prosecutions by federal agencies so far this fiscal year, which is a 24 percent increase over all of 2010. It is a 71 percent increase over five years ago, according to TRAC statistics reported by USA Today. At the current pace, prosecutions will be up 85 percent by the Sept. 30 end of the fiscal year.

The prosecution figures were boosted by the largest-ever federal health-care fraud case that resulted in the arrest of 111 people in cities for bilking the system out of more than $225 million in fraudulent billing schemes that included false claims, kickbacks, identity theft and money laundering. The busts were the work of the Medicare Fraud Task Force, which has seen 24 trial convictions for Medicare fraud in the first eight months of this fiscal year. It is one more than all of fiscal 2010, when the government recovered $4 billion in fines and restitution from fraud convictions.

“That’s just the beginning,” said U.S. Assistant Attorney General Lanny Breuer. “We’re just going to build on this model, and we’re going to hold those responsible who are stealing from the government.”

The government also added two health care fraud teams earlier this year. The stepped- up enforcement stems in part from the federal health care law, which expanded enforcement, too, aimed at saving $4.9 billion from fraud and abuse over the next 10 years.

That is money that can be put back into the system to pay for legitimate health care needs and reduce costs to taxpayers and beneficiaries.