HHS posts record year in Medicare fraud fight

The U.S. Department of Health and Human Services (HHS) reported a record year for recoveries and prosecutions last year as a result of its stepped-up efforts to stamp out Medicare fraud and abuse.

During fiscal year (FY) 1997, which ended on Sep. 30, HHS identified $1.2 billion in total fines, restitutions, settlements, and recoveries — the most ever identified in a single year. That total was six times higher than recoveries during the previous year and more than triple the number in the previous best year for recoveries.

In addition, criminal and civil prosecutions totaled 1,340 cases in FY 1997 — double the number that were brought to court in FY 1996 and more than five times the total number in FY 1995.

Adding to its success, more than 2,700 health care providers and entities were excluded from doing business with Medicare, Medicaid, and other federal and state health care programs for engaging in fraud or abuse of the programs — an 86% increase from the 1,400 exclusions in FY 1996.

Since 1993, actions affecting HHS programs alone have saved taxpayers more than $20 billion and increased health care fraud convictions by 240%, the agency says.