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Medicare Fraud Criminals Beware, Say Feds

by Heather Mayer, DOTmed News Reporter | May 14, 2010
Feds cracking down on fraud
Kathleen Sebelius, secretary of the Department of Health and Human Services (HHS), warned criminals who commit Medicare and Medicaid fraud to watch out, as the government begins to crack down on fraud cases.

"We're going to attack fraud at every stage of the process," Sebelius said in a press conference Thursday.

Attorney General Eric Holder said "as long as health care fraud pays and goes unpunished, our health care system will remain under siege."

Under the newly enacted Affordable Care Act, it is harder to submit false Medicare and Medicaid claims; providers may be subject to fingerprinting, site visits and criminal background checks before they can bill Medicare and Medicaid. Criminals are more likely to get caught and will face stiffer penalties. In order to support these efforts, the law provides an additional $300 million over the next 10 years for law enforcement.

"Anti-fraud programs pay for themselves," Sebelius said. "Going after fraud is one of best investments we can make."

The government reported that it recovered $2.5 billion in overpayments for the Medicare trust fund last year, resulting from fraud enforcement in health care. And for the fiscal year ending Sept. 30, 2009, the government won or negotiated more than $1 billion in judgments and settlements, and investigators opened 1,014 new criminal health care fraud investigations, involving nearly 2,000 defendants.

"The country is getting long overdue good news about health care," Sebelius said.

Moving forward, the government wants to educate citizens about health care fraud, noting in particular, that there are no new Medicare identification cards -- a recent Medicare scam.

"The best protection against fraud is educated consumers," Sebelius told Americans.

Watch DOTmed News for regular reports on fraud cases and prevention activities.