As prepared for delivery
Thank you, Secretary [Kathleen] Sebelius. It’s a pleasure to join you – along with Inspector General [Dan] Levinson and Dr. [Peter] Budetti – in providing an update on the latest efforts by the Departments of Justice and Health and Human Services to combat health-care fraud – and, specifically, to protect taxpayer dollars and ensure the strength of our Medicare and Medicaid programs.
In the fight against health-care fraud, our Departments have a long history of working collaboratively – and effectively. The “Health Care Fraud and Abuse Control Program Annual Report” that we are submitting to Congress today underscores this fact. This report outlines our health-care fraud prevention and enforcement achievements over the last fiscal year. And it demonstrates that our collaborative efforts to prevent, identify, and prosecute the most egregious instances of health-care fraud have never been stronger.
Our success reflects an Administration-wide commitment to combating health-care fraud in all its forms. Over the years, we’ve seen that as long as these crimes go unpunished, our health-care system will remain under siege. And we’ve learned that these crimes harm all of us – government agencies and programs, insurers and health-care providers, and individual patients. But, together, we are fighting back – in bold, innovative, and coordinated ways. And, today, I am proud to report that we are continuing to make meaningful, measurable progress.
As Secretary Sebelius just mentioned, during the last fiscal year – as a result of our joint efforts – we were able to recover nearly $4.1 billion in funds stolen or taken improperly from federal health-care programs. This is an unprecedented achievement – and it represents the highest amount ever recovered in a single year.
Over the same period, the Justice Department’s Criminal Division and our U.S. Attorneys’ Offices opened more than 1,100 new criminal health-care fraud investigations and had more than 1,800 health-care fraud criminal investigations pending. We reached an “all-time high” in the number of health-care fraud defendants charged – more than 1,400 in nearly 500 cases. And we secured more than 700 convictions. And I am particularly proud to note that FBI activity resulted in the dismantling of nearly 70 criminal enterprises engaged in health-care fraud, and the operational disruption of more than 230 criminal fraud organizations.
In addition, the Justice Department’s Civil Division and U.S. Attorneys’ Offices opened nearly 1,000 new civil health-care fraud investigations and had more than 1,000 pending cases. And they recovered approximately $2.4 billion under the False Claims Act alone.
These are stunning numbers. And they would not be possible without the unprecedented DOJ-HHS partnership formed by the Health Care Fraud Prevention & Enforcement Action Team, or HEAT.
In establishing this task force in 2009, 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 and streamline our efforts.
In the nearly three years since, HEAT has elevated our nation’s fight against both civil and criminal health-care fraud. And we’ve ensured that this work is a Cabinet-level priority. Today, we’re bringing the full resources of the federal government to bear against individuals and corporations who illegally divert taxpayer resources for their own gain. And this approach has enhanced our ability to bring abuse to light and criminals to justice.
One key part of this success comes from our Medicare Fraud Strike Forces, which are at the core of HEAT’s law enforcement mission. On the criminal side, our agencies have expanded Medicare Fraud Strike Forces to nine locations – from Miami and Los Angeles, to Detroit, Houston, Brooklyn, Baton Rouge, Tampa, Chicago, and Dallas – where Medicare data show hot spots of unexplained billing levels.
In the last fiscal year, Strike Force prosecutors from U.S. Attorneys’ Offices and the Justice Department’s Criminal Division charged a record total of 323 defendants with seeking to defraud Medicare of more than $1 billion in taxpayer dollars.
This fiscal year also saw two historic federal health-care fraud takedowns: the largest ever – measured by number of defendants – in which Strike Force prosecution teams charged 115 individuals in nine cities for their alleged involvement in false billing schemes totaling more than $240 million; and the largest ever – measured by fraudulent billings – in which 91 defendants were charged in eight cities for more than $290 million in alleged false billings.
These accomplishments reflect this Administration’s ongoing and intensive efforts to protect the American people and to safeguard precious taxpayer dollars. I believe we can all be proud of this great work, performed by the Justice Department's attorneys, agents, analysts, and investigators – and by our partners at HHS. It reflects a joint commitment to fiscal accountability, combating fraud, and returning resources to the U.S. Treasury, state treasuries, and the Medicare Trust Fund. And it’s just one of many ways this Administration is working to help the American people at a time when budgets are tight. In fact, as Secretary Sebelius noted, over the last three years, for every dollar we spent combating health-care fraud, we were able to return an average of seven dollars to the U.S. Treasury, the Medicare Trust Funds, and others. That’s right – seven dollars recovered for every dollar spent on health-care fraud enforcement.
Despite these remarkable successes, we cannot rest. Instead, we must take our work to the next level. To help augment this work, we plan to expand our anti-fraud strategies and techniques under the tough new rules and authorities provided under the landmark Affordable Care Act. This law has proven to be an essential tool in this fight. Working with our federal, state, local and tribal law enforcement partners, we will continue to use the capabilities – as well as the $350 million for Health Care Fraud and Abuse Control activities – that it provides to stop health-care fraud in its tracks. And we will keep up our fight to ensure that fraudsters cannot use this historic legislation to perpetrate health-care fraud on our senior citizens and other vulnerable Americans. At every turn, my colleagues and I remain committed to punishing these criminals to the fullest extent of the law, and bringing justice to those who seek to take billions of dollars from the pockets of taxpayers.
We’re also engaging the private sector in this fight, through important forums like the national and regional HEAT Summits that Secretary Sebelius and I have convened across the country. 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 like to turn things back over to Secretary Sebelius.