- During fiscal year 2015, the U.S. government recovered $2.4 billion from healthcare fraud judgments, settlements and administrative impositions in fraud cases and proceedings, according to a press release.
- The windfall was largely the result of the Health Care Fraud and Abuse Control Program, a joint effort of HHS and the Department of Justice (DOJ).
- HCFAC is one in a toolkit of programs that help the government fight Medicare and Medicaid fraud.
Since 1997, HCFAC has reclaimed $29.4 billion for the Medicare trust funds. Last year’s take amounted to $6.10 for each dollar invested, the DOJ said.
HCFAC also helps to fund improvements in fraud detection technology used by the HHS Office of Inspector General and CMS. Using leads from the Fraud Prevention System, CMS saved $820 million in its first three years of implementation.
Another tool the government uses is the Health Care Fraud Prevention Partnership, an Obama administration initiative that promotes information exchange and payer/provider best practices in the public and private sector. The program has led to payment system edits, revocations and payment suspensions to halt fraudulent payments, according to the DOJ.
The government also recovered nearly $2 billion in federal False Claims Act settlements and judgments related to Medicare and Medicaid fraud, Becker’s Hospital Review reported.