Healthcare fraud recovery pays for itself - and then some | On Call

February 12, 2013 by MassDevice staff

Efforts to combat healthcare-related fraud and abuse have paid for themselves several times over, and the last 3 years have set a new high average for the program's return on investment.

MassDevice On Call

MASSDEVICE ON CALL — For every $1 regulators spend fighting healthcare fraud and abuse during the last 3 years they recovered a record $7.90, the highest 3-year average return to date.

Healthcare fraud prevention programs collected $4.2 billion in fiscal year 2012, up from about $4.1 billion in 2011. Over the last 4 years the policing initiatives have recovered $14.9 billion, according to an official report.

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"This was a record-breaking year for the Departments of Justice and Health & Human Services in our collaborative effort to crack down on healthcare fraud and protect valuable taxpayer dollars," Attorney General Eric Holder said in prepared remarks. "In the past fiscal year, our relentless pursuit of healthcare fraud resulted in the disruption of an array of sophisticated fraud schemes and the recovery of more taxpayer dollars than ever before."

Healthcare regulators attributed the success to the Health Care Fraud Prevention and Enforcement Action Team, an initiative formed in 2009 to protect the Medicare and Medicaid programs from fraud, waste and abuse.

"Our historic effort to take on the criminals who steal from Medicare and Medicaid is paying off: We are gaining the upper hand in our fight against health care fraud," HHS Secretary Kathleen Sebelius said in a statement. "This fight against fraud strengthens the integrity of our health care programs and helps us fulfill our commitment to our seniors."