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DOJ and HHS Announce Record-Breaking Recoveries Resulting from Joint Efforts to Combat Health Care Fraud

Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius today released a new report showing that for every dollar spent on health care-related fraud and abuse investigations in the last three years, the government recovered $7.90. This is the highest three-year average return on investment in the 16-year history of the Health Care Fraud and Abuse (HCFAC) Program.

These findings, released today in the FY2012 Health Care Fraud and Abuse (HCFAC) Program Report, are a result of President Obama making the elimination of fraud, waste and abuse, particularly in health care, a top priority for the administration.

The success of this joint Department of Justice and HHS effort was made possible by the Health Care Fraud Prevention and Enforcement Action Team (HEAT), created in 2009 to prevent fraud, waste and abuse in the Medicare and Medicaid programs and to crack down on individuals and entities that are abusing the system and costing American taxpayers billions of dollars. These efforts to reduce fraud will continue to improve with new tools and resources provided by the Affordable Care Act.

To fight fraud, waste and abuse in the Medicare and Medicaid programs, the Obama Administration has continuously added new resources and significantly expanded funding for others, including the Administration for Community Living’s Senior Medicare Patrol Program (SMP)—groups of senior citizens who educate and empower their peers to identify, prevent and report health care fraud. In 2012, HHS Secretary Sebelius awarded 54 states and territories with funding to support SMP programs. Last year, these programs taught more than 2 million beneficiaries how to look for Medicare fraud. Since 1997, more than 1.5 million seniors and their caregivers have contacted the Senior Medicare patrol to ask questions or report potential fraud.