Industry News

HHS and DOJ Release FY 2014 Health Care Fraud and Abuse Control Program Report.

The Department of Health and Human Services (HHS) and the Department of Justice (DOJ) recently released the fiscal year (FY) 2014 Health Care Fraud and Abuse Control (HCFAC) Program Annual Report.

Highlights of the report include:

  • Recovery of $2.3 billion from judgments and settlements due to health care fraud prevention and enforcement efforts;
  • Recovery of approximately $3.3 billion paid to the federal government or private persons;
  • Return of approximately $1.9 billion to the Medicare Trust Funds and over a half billion in Medicaid money to the U.S. Treasury;
  • Institution of 924 new criminal health care fraud investigations;
  • Filing of charges in 496 cases involving 805 defendants;
  • Conviction of 734 defendants for health care fraud related crimes; and
  • Exclusion of 4,017 individuals and entities from federal health care programs.

Since 1997, the HCFAC Program has returned approximately $27.8 billion to the Medicare Trust Funds and U.S. Treasury.  This translates to a return of approximately $7.70 to the government for every dollar spent on health care-related fraud and abuse investigations.

The HCFAC Program Annual Report for FY 2014 is available at:

https://oig.hhs.gov/publications/docs/hcfac/FY2014-hcfac.pdf.

The CMS Fact Sheet is available at:

http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-03-19.html.

Department of Health and Human Services Office of Inspector General and Department of Justice.  “The Department of Health and Human Services and The Department of Justice Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2014.”  19 Mar. 2015.

The Centers for Medicare & Medicaid Services.  “The Health Care Fraud and Abuse Control Program Protects Consumers and Taxpayers by Combating Health Care Fraud.”  Fact Sheet.  19 Mar. 2015.