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Strengthening Criminal Enforcement:
In recent years, the Department has stepped up its enforcement efforts related to health care fraud, including the following accomplishments in Fiscal Year 2007:
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Recovering Payments through Civil Enforcement:
Also in FY 2007, the Department continued its civil enforcement efforts under the False Claims Act to combat fraud involving a wide spectrum of health care providers and suppliers including doctors, dentists, hospitals, pharmacies, durable medical equipment providers, home health providers, and pharmaceutical and device manufacturers.
Some recent civil enforcement actions include:
Medicare Fraud Strike Force:
In May 2007, the Departments of Justice and Health and Human Services launched the Medicare Fraud Strike Force. The Department's Fraud Section of the Criminal Division, along with the U.S. Attorneys' Offices for the Southern District of Florida and Central District of California lead the strike force teams that are implementing a targeted criminal, civil and administrative effort against individuals and health care companies that fraudulently bill the Medicare program. These efforts include:
85 cases indicted and involving charges filed against 139 defendants who collectively billed the Medicare program nearly $440 million;
92 guilty pleas negotiated and eight jury trials litigated, winning guilty verdicts against 11 additional defendants;
Sentences to incarceration for 86 defendants, averaging 43 months of imprisonment.
Some recent Strike Force prosecutions include:
Other HCFAC Successes:
Since the inception of the HCFAC program in 1997, the Department's criminal and civil enforcement efforts funded by this program, along with partners from the Department of Health and Human Services, and Medicaid Fraud Control Units, have:
-- U.S. Attorneys' Offices opened 878 new criminal health care fraud investigations involving 1,548 potential defendants.
SOURCE U.S. Department of Justice
