Government fraudbusters

U.S. on pace to prosecute more than 1,300 for health care fraud

August 31, 2011

Federal health care fraud prosecutions are on pace to rise 85% over last year, partly because of increased enforcement efforts by the Obama administration, according to data from the Transactional Records Access Clearinghouse (TRAC).

In 2010, government health fraud investigations yielded about $4 billion after the federal health reform law created one agency and expanded another. The Medicare actuary predicted the overhaul over the next decade will yield about $4.9 billion in fraud and abuse savings.

In the first eight months of 2011, 903 people have been prosecuted for health fraud through federal agencies, up 24% from 2010, when 731 people were prosecuted. According to TRAC, the number of prosecutions has increased by 71% across the past five years.

"The trend certainly looks accurate and on track with our data," a Department of Justice (DOJ) spokesperson said. She cited a large case in which the Medicare Fraud Task Force accused 111 physicians, nurses, and executives of falsely billing Medicare more than $225 million. The assistant attorney general of DOJ's criminal division said task force convictions have also increased (Kennedy, USA Today, 8/29).