Federal Agencies collected $1.47B in fraud from government health insurance programs in FY 2005

Oct 8 2006

The Department of Justice and the HHS Office of Inspector General in a report issued this week announced that their joint Health Care Fraud and Abuse Control Program -- which attempts to reduce waste, fraud and abuse in federal health care programs -- will collect $1.47 billion from criminal or civil cases brought during fiscal year 2005, The Hill reports.

Congress created the program through a 1996 statute that increases the two agencies' budgets with money from the Medicare trust fund under the condition that the money is returned through settlements, fines, recoveries and other penalties.

The program coordinates the antifraud efforts of federal, state and local law-enforcement authorities to apprehend offenders. It also guides companies and individuals working with government health care programs on how to avoid fraud. In FY 2005, HHS OIG and DOJ spent $240.6 million of the Medicare trust fund and deposited $1.55 billion from their antifraud efforts -- the total includes money from cases settled in earlier years and excludes cases settled in FY 2005 that will be paid off in future years.

Since the antifraud program began in 1997, a total of $8.85 billion has been deposited in the trust fund.

Fraudulent activities by individuals and companies include illegally distributing strictly controlled narcotics, selling counterfeit drugs online, overcharging Medicare and providing physician kickbacks (Young, The Hill, 10/5).