Government Sees a Record Surge in Healthcare Fraud Prosecution

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Government Sees a Record Surge in Healthcare Fraud Prosecution

New statistics released by independent research organization TRAC (Transactional Records Access Clearinghouse) show that the number of health care fraud prosecutions is set for a dramatic rise this year. Syracuse University organization TRAC releases government data obtained from submissions under the Freedom of Information Act. According to a recent report, there have been 903 new prosecutions in the first 8 months of 2011. That amounts to 24% more than the total number of prosecutions for the entire fiscal year 2010. It is projected that FY 2011 will bring in 1355 prosecutions, if activity continues at this rate, which would be an 85% increase over 2010.

The dramatic rise is attributed partly to the Obama Administration’s increase in staff this year, adding two health care fraud teams in February. A USA Today article cited U.S. Department of Justice spokeswoman Alisa Finelli, who confirmed the surge in health care fraud prosecution. Ms. Finelli noted, “The trend certainly looks accurate and on track with our data.” She also described the successful bust by the Medicare Fraud Task Force in February of 111 people accused of falsely billing Medicare more than $225 million, which was the was largest such apprehension in its history. The task force has also been able to secure a record number of health care fraud convictions, with 24 in the first 8 months of 2011 (up from 23 in FY 2010).

The FBI’s health care fraud criminal investigation unit has seen a large increase in cases as well. They have begun to focus on major providers (such as hospitals or corporations) and criminal enterprises, which are often identified through the help of whistleblowers. $300 million in rewards was paid to these whistleblowers in 2010 alone. Recovery by the government in healthcare fraud cases has also reached record levels in the past year, with a total of $4 billion recovered in FY 2010.

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