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Attorney General Eric Holder Speaksat the Health Care Fraud Summit in Philadelphia


Philadelphia, PA
United States

Good morning.  It’s a pleasure to join with Secretary Sebelius in welcoming you here today – and I want to thank the University of Sciences in Philadelphia for hosting this important discussion. 

I also want to recognize my colleagues – Assistant Attorney General Tony West, who leads the Justice Department’s Civil Division, and this city’s outstanding United States Attorney, Zane Memeger – for the work that they have done to bring us all together.  And I’m especially grateful for their extraordinary efforts to prevent and to combat health care fraud across this region, and beyond. 

They understand – and we all have seen in recent years – that, when it comes addressing a challenge as urgent, as complex, and as widespread as health care fraud, we need an innovative, proactive, and collaborative approach.

That’s what today’s summit is all about.  And that’s why, just last month, Zane convened this area’s first-ever Health Care Fraud Working Group meeting, which also brought together local health care providers, insurers, prosecutors, fraud investigators, auditors, and federal, state and local law enforcement officials.

That meeting marked the beginning of a critical dialogue – a conversation that we’re continuing, and building on, today.  By coming together, we’re signaling – to the citizens we serve and to those who would threaten the strength of our health care system – that a new era of communication and cooperation has begun, and that this Administration’s commitment to fighting health care fraud has never been stronger.

Thank you all for being part of this work.  With your assistance and ongoing engagement, I have no doubt that we will see continued success in protecting patients, consumers, and taxpayer resources; in bringing criminals to justice; and in building on what’s been achieved through the Health Care Fraud Prevention and Enforcement Action Team, known as “HEAT.” 

Just over two years ago, in May 2009, the Departments of Justice and Health and Human Services joined forces to create this historic initiative.  We were inspired by our common cause – and by common sense.

We saw – clearly – that the best way to strengthen our individual efforts to combat health care fraud was to work together.  And the results of this partnership – and the outstanding efforts of our Medicare Strike Forces, along with other dedicated investigators and prosecutors across the country – speak for themselves.

Over the last two years – as a result of health care fraud actions we have pursued under the False Claims Act and the Food, Drug and Cosmetic Act – the Justice Department’s Civil Division and our U.S. Attorneys’ Offices have recovered nearly $8 billion in judgments, settlements, fines, restitutions, and forfeitures.  Last year alone, we opened more than 900 civil investigations – and secured more than 700 criminal convictions against individuals involved in health care fraud schemes.

This work is making a meaningful, measurable difference in communities nationwide.  That’s certainly true here in Philadelphia.  In the last two years, we've collected a record amount in health care fraud recoveries – more than $2.5 billion, which includes one of the largest settlements involving a single company in the history of the Justice Department.

Since the beginning of this year, in Eastern Pennsylvania, federal prosecutors have won a conviction – and a three-year sentence – against a chiropractor who attempted to bill nearly two million dollars to a private insurer for treatments that he had never actually performed.  We’ve charged an ophthalmologist who allegedly falsified more than $3 million in fraudulent charges to health care benefit programs.  And we are seeking justice against the operators of a private ambulance company who allegedly billed Medicare for the unnecessary transportation of healthy patients.

These cases, and countless other local civil and criminal enforcement actions, are evidence of – and an essential part of – our nationwide success.  To put it simply, our collaborative efforts are working.  We are striking a blow against deceptive practices across the country – and working to shut down health care fraud schemes and prevent the devastation that they can cause to individuals, families, and communities.

The progress that we’re seeing is not only evidence of our agencies’ commitment to combating health care fraud and, specifically, to protecting taxpayer dollars and the integrity of our Medicare and Medicaid programs.  It’s evidence of this Administration’s broad-based commitment to fiscal responsibility and accountability – a commitment that inspired the recent launch of the Campaign to Cut Waste – a promising new initiative aimed at identifying and eliminating waste, fraud, and abuse from our essential health care programs.

I look forward to what this will help us accomplish.  But I can tell you, already, that – when it comes to meeting the goals that we all share – government can’t do it alone.

We need the insights and expertise of state and local leaders, industry experts, law enforcement officers, health care-providers, consumers, and even victims.  There’s no question that we need strong public-private partnerships – and to bring even more participants into conversations like this one.

So, where do we go from here?

First, we must strengthen HEAT.  I assure you that its work will remain a top priority of the Justice Department.  And Secretary Sebelius and I will continue working to leverage our agencies’ respective resources and expertise – including the FBI and the Office of Inspector General at HHS – to prevent and to prosecute fraud.  We will continue to work closely with local U.S. Attorneys Offices to pursue both civil and criminal cases.  And – as we bring these criminals to justice – we will utilize the Internet and the media to inform the public and the health care industry about how they can help prevent future fraud schemes.

Second, we’ll continue to support our Medicare Fraud Strike Forces and work to expand their reach – and highly successful efforts.

Third, our agencies will continue to work with Congress to identify and pursue the legislative and regulatory reforms necessary to prevent, deter, and prosecute health care fraud.  These reforms range from removing barriers that impede information-sharing to increasing sanctions and penalties for offenders.

Finally, t he Department will continue to engage key stakeholders in the private sector in our anti-fraud efforts.  Events like this summit, and the Health Care Fraud Working Group, are critical parts of this process.  As we move forward, we will seek out guidance from representatives of the insurance industry and in the health care-provider community – and I’m glad to see so many private sector partners here today.  We know that the vast majority of those who work in the health care industry are honest people who want to help patients and follow the law.  But we also know that a few bad apples have created an industry-wide problem that cannot be ignored.  You all have a crucial role to play in helping us to encourage good behavior, bring waste and abuse to light, and hold criminals accountable. 

So long as these crimes go unpunished, our health care system will remain under siege.  Fraud harms all of us – government agencies and programs, industries and individuals.  But, through HEAT and with your support on the local level, we are fighting back.  We welcome – and we need – your assistance in this shared enterprise.

Your presence at this summit – and the fine work that has been done here in Philadelphia already – fills me with hope for the future progress of our common efforts.  I’m optimistic about what we can accomplish together, and I look forward to working with you all.

Thank you.

Updated August 18, 2015