Good morning. It’s a pleasure to join Secretary Sebelius, Deputy Administrator Budetti, Assistant Attorney General Lanny Breuer, and U.S. Attorney Birotte in welcoming you. I want to thank each of you for your participation in today’s discussion and for your partnership in the fight against health care fraud.
Looking around, I’m encouraged by the diversity of perspectives represented here. And I’m glad to see that top federal and state officials, administration leaders, federal, state, and local law enforcement officers, health care providers, as well as area patients, physicians, business executives, and caregivers have come together for this critical summit. Each one of us shares the same concerns about the devastating effects of health care fraud. We share the same goals of protecting potential victims, safeguarding precious taxpayer dollars, and ensuring the strength of our health care system. And – despite the commitment you represent and the great work being done across and beyond Los Angeles – we can all agree that it’s time to take our nationwide fight against health care fraud to the next level.
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 Secretary Sebelius and I convened the first “National Summit on Health Care Fraud” in Washington in January. Last month, we kicked off a series of regionally-focused conversations in Miami, where we also announced the results of the largest federal health care fraud takedown in our nation’s history. We decided that the next regional initiative should be held here in L.A., which – I don’t have to tell any of you – unfortunately has become a “hot spot” for health care fraud schemes.
You all know what we’re up against. In communities across this region, our health care system is under siege – exploited by criminals intent on lining their own pockets at the expense of American taxpayers, patients, and private insurers. Here in L.A., these crimes have reached crisis proportions, driving up health care costs for everyone and also hurting the long-term solvency of our essential Medicare and Medicaid programs.
But we are fighting back – in bold, innovative, and coordinated ways.
Last year brought an historic step forward in this fight. In May 2009, the Departments of Justice and Health and Human Services launched the Health Care Fraud Prevention and Enforcement Action Team, or “HEAT.” Through HEAT, we’ve fostered unprecedented collaboration between our agencies and our law enforcement partners. We’ve ensured that the fight against criminal and civil health care fraud is a Cabinet-level priority. And we’ve strengthened our capacity to fight health care fraud through the enhanced use of our joint Medicare Strike Forces.
This approach is working. In fact, HEAT’s impact has been recognized by President Obama, whose FY2011 budget request includes an additional $60 million to expand our network of Strike Forces to additional cities. With these new resources, and our continued commitment to collaboration, I have no doubt we’ll be able to extend HEAT’s record of achievement. And this record is extraordinary.
In just the last fiscal year, we’ve won or negotiated more than $1.6 billion in judgments and settlements, returned more than $2.5 billion to the Medicare Trust Fund, opened thousands of new criminal and civil health care fraud investigations, reached an all-time high in the number of health care fraud defendants charged, and stopped numerous large-scale fraud schemes in their tracks.
We can all be encouraged, in particular, by what’s been accomplished in L.A. Criminals we’ve brought to justice here – in the last year alone – include the owners of the City of Angels Hospital, who pleaded guilty to paying illegal kickbacks to homeless shelters as part of a scheme to defraud Medicare and Medi-Cal; a physician in Torrance who defrauded insurance companies by misrepresenting cosmetic procedures as “medically necessary”; an Orange County oncologist who pleaded guilty to fraudulently billing Medicare and other health insurance companies up to $1 million for cancer medications that weren’t provided; a Santa Ana doctor who pleaded guilty to health care fraud for giving AIDS and HIV patients diluted medications; and a ring of criminals whodefrauded Medi-Cal out of more than $4.5 million by using unlicensed individuals to provide in-home care to scores of disabled patients, many of them children.
These are just a few of many local schemes that have been – aggressively and permanently – shut down. And they’re all proof that we can make measurable, meaningful progress in the fight against health care fraud. But we cannot do it alone. We need your help. We need your unique insights. And we will rely on your recommendations to help guide and enhance HEAT’s critical work.
Despite all that’s been accomplished since HEAT was launched, health care fraud remains a significant problem. At this very moment, for example, we know that an alarming number of scam artists and criminals are attempting to profit from misinformation about the Affordable Care Act.
That’s why, early this summer, Secretary Sebelius and I wrote to all state attorneys general, urging them to develop outreach campaigns to educate seniors and other Medicare beneficiaries about how to protect themselves and help prevent scams. Each of you can be part of this and other public education efforts. Each of you can help to ensure that our hard-won health reform achievements are not exploited.
The good news is that the Affordable Care Act provides new resources and includes tough new rules and penalties to help stop and prevent health care fraud. We will continue to work vigorously with our law enforcement and private sector partners to ensure that those who engage in fraud cannot use this new legislation to steal from 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 is our promise.
As we work to build on the progress that’s been made, your presence here today gives me great hope about what we can accomplish together. 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 Assistant Attorney General for the Criminal Division, Lanny Breuer.