Federal Government Highlights New Tools to Fight Fraud

April 20, 2012 Author: Selina Coleman


Key industry sectors

The Obama Administration – which recovered almost $4.1 billion last year – announced that:

  • 234 providers were removed from the program because they were deceased, debarred, excluded by other federal agencies, or were otherwise false or invalid.
  • HHS revoked 4,850 Medicaid providers and suppliers, plus it deactivated 56,733 Medicare providers and suppliers.
  • HHS saved $208 million through pre-payment edits that block payment on implausible claims.
  • The number of individuals charged with fraud increased by nearly 75% from fiscal year 2008 to fiscal year 2011.
  • More than 49,000 complaints of fraud reported to 1-800-MEDICARE were referred for further evaluation.
  • The new re-design of the quarterly Medicare Summary Notices received by Medicare beneficiaries will help them find and report fraud.

At the summit, Secretary Sebelius gave "a simple message to criminals thinking about committing Medicare fraud: don't even try."  She explained that "thanks to health reform and our Administration's work, we have new tools and resources to catch criminals and stop Medicare fraud before it happens."  To read the government's press release about its Chicago summit on health care fraud prevention, click hereSelina Spinos

Fulbright & Jaworski L.L.P. Washington's Health Care Group

Cori Annapolen Goldberg
202 662 0436

Peter Leininger
202 662 0278

Tom Dowdell
202 662 4503

Lesley Reynolds    
202 662 0247

Mark Faccenda
202 662 0306

Rick Robinson
202 662 4534

Megan Fanale Engel*
202 662 4733

Joel Slomoff
202 662 4688

Glenn Jones
202 662 4605

Selina Spinos
202 662 4536

*Ms. Engel is admitted to practice only in Virginia.  Practice
supervised by principals of the firm admitted in the District of Columbia