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DOJ, HHS Announce $4.2B in Medicare Fraud Recoveries

John Commins, for HealthLeaders Media, February 12, 2013

For every dollar spent investigating Medicare fraud and abuse in the last three years the federal government recovered $7.90. That return on investment is the highest three-year average in the 16-year history of the Health Care Fraud and Abuse Program, federal officials announced on Monday.

"Our historic effort to take on the criminals who steal from Medicare and Medicaid is paying off: We are gaining the upper hand in our fight against healthcare fraud," Health and Human Services Secretary Kathleen Sebelius said in prepared remarks.

"This fight against fraud strengthens the integrity of our healthcare programs and helps us fulfill our commitment to our seniors."

The HCFAC—a joint initiative of the Department of Justice and HHS—in its annual report said that the government recovered $4.2 billion in fiscal 2012 and $4.1 billion in fiscal 2011.

Over the last four years federal officials have recovered $14.9 billion—up from $6.7 billion in the prior four year period—from drug companies, hospitals, physicians, healthcare executives, vendors and assorted scam artists. Since 1997 HCFAC has returned more than $23 billion to the Medicare Trust Funds.

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