The DOJ had something worth bragging about Tuesday, as they announced a record-breaking $4.1 billion in stolen health care funds was recovered by officials in fiscal year 2011.The figure was included in the annual Health Care Fraud and Abuse Control Program report released by the Dept. of Health and Human Services. (See how 50 million Americans are living without insurance.)
$4.1 billion is nothing to sniff at, but some reports estimate that Medicare fraud and improper payments cost the beleaguered program a staggering $100 billion per year, according to the Fiscal Times.
Regardless, this is a win for the two-year-old Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint DOJ/HHS initiative tasked with cracking down on health care abuse.
Last year, nine HEAT teams stationed in cities across the country reeled in more than 320 defendants who allegedly stole $1 billion from Medicare. Of those, they rendered 172 guilty pleas, convicted 26 and sentenced 175 to prison. The average fraudster will face more than 47 months behind bars.
But that’s just the HEAT teams’ haul. Federal prosecutors also charged more than 1,400 defendants with health care fraud and related crimes – the highest number recorded in a single year in the DOJ’s history. More than half of arrests lead to convictions, according to the report.
Here are some other figures that stood out:
-$1.3 billion in fines recovered from crimes in the pharmaceutical and device manufacturing industry
-$2.4 billion recovered from civil health fraud cases (illegal marketing of medical devices, violations of laws against self-referrals and kickbacks, etc.)
-A total of $6.6 billion recovered under the False Claims Act since 2009