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HHS, DOJ recovered record $4.1B in 2011

DOJ convicted more than 700 health care fraudsters in 2011

Topics: Revenue Cycle, Finance, Billing and Collections

February 16, 2012

HHS Secretary Kathleen Sebelius and Attorney General Eric Holder on Tuesday announced that their agencies recovered a record-high $4.1 billion in health care fraud judgments in 2011, about 50% more than in 2009.

Federal officials on Monday said the increased recovery rate can be attributed to new fraud-fighting tools. The Department of Justice (DOJ) and HHS said they have strengthened enrollment requirements and that both agencies are more thoroughly screening health care providers. About 1,400 people were charged with fraud in 2011, leading to more than 700 convictions.

Investigators also are conducting site visits to ensure that moderate-risk providers have legitimate offices. Meanwhile, high-risk providers are subject to background checks and fingerprinting. The officials also noted that they are doing a better job of sharing data between agencies.

Holder said fraud strike force teams in fraud hot spots such as Miami, Detroit, and Los Angeles "reflect a strong, ongoing commitment to fiscal accountability and to helping the American people at a time when budgets are tight." DOJ officials also praised judges for increasing sentences for fraudulent activity from an average of 42 months in 2010 to more than 47 months in 2011 (Carlson, Modern Healthcare, 2/14 [subscription required]; AHA News, 2/14; AP/Washington Post, 2/13).

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