Thank you, President [Allan] Gilmour. It’s a pleasure to be with you, and I want to thank you – and the entire Wayne State community – for welcoming us to this beautiful campus and for hosting this important summit.
I’m proud to join with Secretary Sebelius – and with United States Attorney [ Barb] McQuade – in welcoming you all here. And I want to thank each of you for your participation in today’s discussion – and for your partnership in our national fight against health care fraud.
As we explore ways to build on current efforts and recent achievements, I’m encouraged by the diversity of perspectives represented here. We’re joined by top federal and state officials; administration leaders; federal, state, and local law enforcement officers; health care providers; as well as leading physicians, business executives, caregivers, health care anti-fraud organizations, investigators, prosecutors – and even a few students. As we work to address a problem that – quite frankly – has reached crisis proportions, we will continue to rely on your unique insights – and your ongoing engagement.
Here in Detroit, you know what we’re up against. Throughout this region, where the Detroit Medical Center is the largest private employer – and especially here at Wayne State, the largest single-campus medical school in the country – many of you have witnessed, and raised concerns about, the devastating effects of health care fraud. I want you to know that we share the same goals of protecting potential victims, safeguarding precious taxpayer dollars, and ensuring the strength of our health care system. Despite the strong commitment that you represent and the great work being done across Michigan and beyond – we can all agree that it’s time to redouble our efforts to combat and prevent these crimes more effectively.
That’s what today is all about. This summit is an important step forward – an opportunity to build on what has been discussed, and achieved, since January of last year – when Secretary Sebelius and I convened the first “National Summit on Health Care Fraud” in Washington. This past summer, we kicked off a series of regionally focused conversations so that we could better understand, and more effectively address, the unique challenges being faced in different areas of the country. So far, Secretary Sebelius and I have been to Miami, Los Angeles, New York, and Boston – and we plan to visit additional cities in the coming months. Like Detroit, these locations have become “hot spots” for health care fraud schemes. Here, and across America, these crimes are driving up health care costs for everyone – and also hurting the long term solvency of our essential Medicare and Medicaid programs.
But, together, we are fighting back – in bold, innovative, and well-coordinated ways. And our Health Care Fraud Prevention and Enforcement Action Team, known as “HEAT,” is an essential part of this work.
Since launching HEAT in May of 2009, the Departments of Justice and Health and Human Services have broken down barriers to communication and collaboration. We’re leveraging resources – and sharing information and expertise – like never before. And we’ve brought law enforcement partners at every level into this work. Together, we’ve ensured that our nation’s fight against criminal and civil health care fraud is a Cabinet-level priority. And we’ve strengthened the capacity – and the record of success – of our Medicare Strike Forces.
As we’ve seen in recent months, this approach is working.
In just the last fiscal year, we obtained settlements and judgments amounting to more than $2.5 billion in False Claims Act matters alleging health care fraud – the largest annual figure in history and an increase of more than 50% from fiscal year 2009. We also opened more than 2,000 new criminal and civil health care fraud investigations, reached an all-time high in the number of health care fraud defendants charged, stopped numerous large-scale fraud schemes in their tracks, and returned more than $2.5 billion to the Medicare Trust Fund and more than $800 million to cash-strapped state Medicaid programs.
Here in Detroit, the work of this area’s Medicare Strike Force has resulted in charges against 120 defendants, in 18 separate criminal cases, for fraud schemes totaling nearly $120 million in taxpayer money. So far, eight of these individuals have been convicted, and 63 have pleaded guilty.
Last August, a physician from Farmington Hills was ordered to pay more than $9 million in restitution – and sentenced to 14 years in prison – for his role in a brazen scheme to bribe Medicare beneficiaries and to bill the government millions of dollars for therapies that were never provided.
In December, the president and vice president of a therapy center in Livonia were sent to prison for similar crimes. And just a week and a half ago, the owners and operators of a Detroit-area clinic were sentenced for running a scheme involving fraudulent billings and money laundering. In an attempt to avoid scrutiny, these individuals had relocated their operations from Miami. But – thanks to the excellent work of our Detroit Strike Force – they were identified. They were stopped. And they are being brought to justice.
Our successful criminal prosecutions are clear evidence of the effectiveness of our operations. But our work is far from done. And Secretary Sebelius and I know that – to win this fight against health care fraud – government cannot do it alone.
We need your help. We need your insights. And we will rely on your recommendations to help guide and enhance HEAT’s critical work.
I also want you to know that the Departments of Justice and HHS will continue seeking out opportunities to work with you, to learn from you – and to collaborate with our law enforcement and private sector partners to ensure that those who engage in fraud can no longer prey on taxpayers, patients, seniors, and other vulnerable Americans. We will keep industry leaders informed about emerging fraud schemes and help institute effective compliance and anti-fraud programs. And we will punish offenders to the fullest extent of the law. That’s a promise.
Your presence here today gives me great hope about what we can accomplish together going forward. So, as Secretary Sebelius and I do our part in Washington to build on the progress that’s been made, we look forward to working closely with you – and with state and local officials, officers, leaders, and advocates across the country.
Thank you all, once again, for joining us and for your ongoing commitment to protecting the American people and ensuring the strength and integrity of our health care system. And now, I’d like to turn things over to an extraordinary leader and partner in this work – the Secretary of the Department of Health and Human Services, and my good friend, Kathleen Sebelius.