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Aug 31 2011

Health Care Fraud Prosecutions Increase in 2011

New data from the Transactional Records Access Clearinghouse (TRAC) shows that federal health care fraud prosecutions in 2011 are on track to rise 85% over prosecutions from last year. TRAC attributes the increased prosecutions chiefly to stepped-up fraud enforcement efforts by the Obama administration, including the addition of health care fraud teams.

From January through August 2011, 903 people were prosecuted for health care fraud. According to TRAC, this is a 24% increase over the total prosecutions in 2010, when 731 people were prosecuted for federal health care fraud. The 2011 data also shows a 71% increase from prosecutions just five years ago. Trial convictions resulting from Medicare Fraud Task Force investigations have also increased significantly, with 24 trial convictions in the first eight months of 2011, as compared to 23 trial convictions in all of 2010.

Increased prosecutions have yielded increased savings. In 2010, the government’s health care fraud investigations resulted in $4 billion in recovery. In 2011, the Department of Justice announced its largest Medicare Fraud Task Force case, charging 111 people with falsely billing Medicare for more than $225 million. The Affordable Care Act may also have an effect on fraud and abuse savings. Medicare actuaries predict that over the next decade, $4.9 billion in savings may be available from fraud and abuse provisions in the Affordable Care Act.