Good afternoon. I’m pleased to join Secretary Sebelius in providing an update on our joint efforts to combat health care fraud and, specifically, to protect taxpayer dollars and our Medicare and Medicaid programs.
The Departments of Justice and HHS have a long history of working together in the fight against health case fraud. Today, we are submitting the "Health Care Fraud and Abuse Control Program Annual Report," (HCFAC) which outlines the last fiscal year’s prevention and enforcement achievements. This report shows the success of our collaborative efforts to prevent, identify, and prosecute the most egregious instances of health care fraud.
Over the years, we’ve seen that as long as health care fraud pays and goes unpunished, our health care system will remain under siege. These crimes harm all of us – government agencies and programs, insurers and health care providers, and individual patients. But we are fighting back. As our latest HCFAC report shows, we have made meaningful, measurable progress. In fact, last year brought record levels of achievement.
In the last fiscal year, as a result of our joint efforts, approximately $2.5 billion was deposited to the Medicare Trust Fund – an increase of more than half a billion dollars over the prior year’s total. We also won or negotiated more than $1.6 billion in judgments and settlements. The Justice Department’s Criminal Division and our U.S. Attorneys’ Offices opened more than 1,000 new criminal health care fraud investigations and had more than 1,600 health care fraud criminal investigations pending. We reached an "all-time high" in the number of health care fraud defendants charged, with more than 800 indictments in nearly 500 cases and close to 600 convictions. And the Justice Department’s Civil Division opened nearly 900 new civil health care fraud investigations and had more than 1,100 pending cases.
These numbers, though, tell only part of the story. Last year also brought a critical step forward in our health care fraud fight – the creation of our Health Care Fraud Prevention & Enforcement Action Team, or HEAT.
In establishing this task force last May, our two agencies were inspired by common cause – and by common sense. We realized that, to overcome a problem as complex and widespread as health care fraud, it was time to redouble our efforts. HEAT has elevated our joint fight against both civil and criminal health care fraud as a Cabinet-level priority. We’re bringing to bear the full resources of the federal government against individuals and corporations who illegally divert taxpayer resources for their own gain. And our approach is working. So far, HEAT has enhanced our ability to bring abuse to light and criminals to justice. And it’s enabled the recovery of stolen funds and the return of millions of dollars to the U.S. Treasury and the Medicare Trust Fund.
Much of this success can be attributed to our Medicare Fraud Strike Forces, which are at the core of HEAT’s law enforcement mission. On the criminal side, through the HEAT initiative, our agencies have expanded Medicare Fraud Strike Forces to seven regions across the country – from South Florida to Detroit to Houston – where Medicare data show hot spots of unexplained billing levels. To date, Strike Force prosecutors from U.S. Attorneys’ Offices and the Justice Department’s Criminal Division have sought approximately $500 million in court-ordered restitution to the Medicare program in nearly 300 health care fraud cases involving more than 560 defendants. More than 300 guilty pleas have been secured, and 250 defendants have been sentenced to prison – with sentences ranging from two months to 30 years. And on the civil enforcement front, our health care fraud recoveries last year under the False Claims Act exceeded a stunning $2.2 billion dollars.
I’m proud of this great work performed by the Justice Department’s prosecutors, agents, analysts and investigators – and by our partners at HHS. These accomplishments reflect this Administration’s ongoing and intensive efforts to protect the American people and to safeguard precious taxpayer dollars. Our commitment to fiscal accountability, combating fraud, and returning resources back to the U.S. Treasury, state treasuries, and the Medicare Trust Fund is just one of many ways we’re working to help the American people at a time when budgets are tight. In fact, for every dollar we spend combating health care fraud, we’re able to return four dollars to the U.S. Treasury and the American taxpayers.
Despite our successes, we cannot rest. Instead, we must take our work to the next level. And we plan to expand our anti-fraud strategies and techniques through the new Affordable Care Act. This law provides new resources and includes tough new rules and penalties. Working with our federal, state, local and tribal law enforcement partners, we will use the expanded capabilities that the Affordable Care Act provides to stop health care fraud in its tracks. And we will work vigorously with all of our law enforcement partners to ensure that fraudsters cannot use this historic legislation to perpetrate health care fraud on our senior citizens and other vulnerable Americans. We will punish these criminals to the fullest extent of the law, and we will bring to justice those who seek to take billions of dollars from the pockets of taxpayers.
We’re also engaging the private sector in this fight. And we will continue to work with industry leaders to share information about emerging fraud schemes and to institute effective compliance and anti-fraud programs.
So, on that forward-looking note, I would now like to turn things over to one of our dedicated partners, the Inspector General of the U.S. Department of Health and Human Services, Dan Levinson.