Approximately $2.51 billion was returned to the Medicare Trust Fund in 2009 as a result of the operations of the Health Care Fraud and Abuse Program, according to a report published this month. The program, run jointly by the Department of Justice and the Department of Health and Human Services since 1997, is designed to coordinate Federal, state and local law enforcement activities with respect to health care fraud and abuse. According to the report, the Federal Government won or negotiated over $1.63 billion in settlements and judgments last year. Since its inception, HCFAP has returned $15.6 billion to the federal coffers.
As criminals have begun targeting the federal health care system, the HCFAP has begun to focus on preventing and prosecuting criminal Medicare fraud. Numbers for 2009 are staggering:
In fiscal year 2009, U.S. Attorneys’ Offices opened 1,014 new criminal health care fraud investigations involving 1,786 potential defendants. Federal prosecutors had 1,621 health care fraud criminal investigations pending, involving 2,706 potential defendants, and filed criminal charges in 481 cases involving 803 defendants. A total of 583 defendants were convicted for health care fraud-related crimes during the year. Also in FY 2009, the Department of Justice (DOJ) opened 886 new civil health care fraud investigations and had 1,155 civil health care fraud matters pending.