U.S. COLLECTS MORE THAN $1.3 BILLION IN 2001
AS A RESULT OF HEALTH CARE FRAUD

WASHINGTON, DC – The federal government collected more than $1.3 billion during 2001 as a result of health care fraud, the Justice Department and the Department of Health and Human Services (HHS) announced today.

More than $1 billion or 90 per cent of the dollars collected in 2001 were returned to the Medicare Trust Fund. An additional $42.8 million was recovered as the federal share of Medicaid restitution – the largest return to the government since the inception of the program. Some of the judgments, settlements and administrative impositions in 2001 will result in collections in future years, just as some of the 2001 collections are attributable to actions from prior years.

The government's efforts in successfully detecting and eliminating health care fraud have grown over the last five years following the passage of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. HIPAA established a national Health Care Fraud and Abuse Control Program, under the joint direction of the Attorney General and the Secretary of HHS, acting through the Department's Inspector General, designed to coordinate federal, state and local law enforcement activities with respect to health care fraud and abuse. HIPAA made available much needed and powerful new criminal and civil enforcement tools and financial resources that permitted the government to expand and intensify the fight against health care fraud.

During the five years of the program, over $2.9 billion has been returned to the Medicare Trust Fund, while returns to the federal government were over $3 billion. In addition, more than 2,000 defendants were convicted for health care fraud-related offenses. Over 15,000 entities or individuals were excluded from participating in Medicare, Medicaid and other federally sponsored health care programs.

Last year, federal prosecutors filed 445 criminal indictments in health care fraud cases. A total of 465 defendants were convicted for health care fraud-related crimes in 2001. There were also 1,746 civil matters pending and 188 civil cases filed at the same time.

During the year, HHS excluded more than 3,756 individuals and entities from participating in Medicare and Medicaid programs or other federally sponsored health care programs, most as a result of convictions for crimes relating to Medicaid or Medicare, for patient abuse or neglect, or as a result of revocation of licenses. This record number of exclusion actions is the result of successful collaboration with state Medicaid Fraud Control Units and states licensing boards.

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