U.S. Attorney General Eric Holder and Secretary of Health and Human Services Kathleen Sebelius reported Tuesday the $4.1 billion was the highest annual amount ever recovered from individuals and companies who attempted to defraud seniors and taxpayers, or who sought payments to which they were not entitled.
The joint Department of Justice and HHS effort -- made possible through the Affordable Care Act -- would not have been possible without the Health Care Fraud Prevention & Enforcement Action Team, created in 2009 to prevent fraud, waste and abuse in the Medicare and Medicaid programs, Holder and Sebelius said.
In FY 2011, the total number of cities with strike force prosecution teams was increased to nine, all of which have teams of investigators and prosecutors from the Justice Department, the FBI, and the HHS Office of Inspector General. The strike force teams use advanced data analysis to identify high-billing levels in healthcare fraud hot spots, allowing interagency teams to target emerging or migrating schemes, along with chronic fraud by criminals masquerading as healthcare providers or suppliers.
Strike force operations in FY 2011 charged a record number of 323 defendants, who allegedly collectively billed the Medicare program more than $1 billion. Strike force teams secured 172 guilty pleas, convicted 26 defendants at trial and sentenced 175 defendants to prison.