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U.S. recovers $4 billion in health fraud payments

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Medicare fraud

The federal government recovered a record $4 billion in health fraud payments during its last fiscal year, including $2.5 billion from healthcare fraud settlements and judgments.

The $2.5 billion the U.S. Justice Dept. won or negotiated from the fraud cases is the largest amount ever recovered and a 50 percent increase over the amount recovered during fiscal 2009, according to associate attorney general Tom Perrelli.

It was a busy year for the Justice Dept., Perrelli said in prepared remarks, with more than 1,100 new criminal healthcare fraud cases opened and 950 new civil fraud investigations — also record numbers for the nation’s top law enforcement agency.

The increases kept prosecutors busy as well, charging more than 930 defendants in the cases to set yet another record. The prosecutors logged more that 700 criminal convictions for healthcare fraud in fiscal 2010, Perrelli said.

It’s part of President Barack Obama’s crackdown on healthcare fraud, launched almost as soon as he took office in early 2009. Kathleen Sebelius, secretary of the U.S. Dept. of Health & Human Services, said the aim is to interdict cash payments before criminals can get their hands on them, according to Bloomberg BusinessWeek.

Obama’s Patient Protection and Affordable Care Act gives new teeth to the government’s bite. A provision of the healthcare reform law that took effect yesterday allows the DoJ to withhold Medicare and Medicaid payments from firms under investigation. The government is also going high-tech in its pursuit of healthcare fraudsters, according to the magazine, using software akin to that used by credit card companies to detect fraudulent charges.

House Republicans remain unimpressed by the recovery, according to the Washington Post, and are planning probes aimed at showing that the Obama administration isn’t doing enough to pursue waste and fraud.

“We can save $125 billion in simply not giving out money to Medicare recipients that don’t exist for procedures that didn’t happen,” Rep. Darrell E. Issa (R-Calif.), the new chairman of the House Oversight and Government Reform Committee, told the Post.

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