“As demonstrated by today’s charges and arrests, we will strike back against those whose fraudulent schemes not only undermine a program upon which 45 million aged and disabled Americans depend, but which also contribute directly to rising health care costs that all Americans must bear.”

– Attorney General Holder

“The Obama Administration is committed to turning up the heat on Medicare fraud and employing all the weapons in the federal government’s arsenal to target those who are defrauding the American taxpayer.”

– HHS Secretary Kathleen Sebelius

Additional Information

* Eight Miami-Area Residents Charged in $22 Million Medicare Fraud Scheme Involving Home Health Care Agencies
* Medicare Fraud Strike Force Operations Lead to Charges Against 53 Doctors, Health Care Executives and Beneficiaries for More Than $50 Million in Alleged False Billing in Detroit
* Fact Sheet: Phase Three Medicare Fraud Strike Force Detroit Metro Area (PDF – 56KB)
* Fact Sheet: Medicare Fraud Strike Force (PDF – 49KB)
* Medicare Fraud Strike Force Map of Detroit (PDF – 303KB)

Turning up the HEAT to Stop Medicare and Medicaid Fraud

Most health care providers are doing the right thing and providing care with integrity. But sadly, due to the illegal actions of a small but active group of heath care fraud perpetrators, billions of dollars are stolen from taxpayers each year. Medicare fraud schemes have grown bolder and more elaborate, resulting in billions of dollars in false billings and fraud schemes which are robbing Medicare and Medicaid blind and leaving our most vulnerable citizens at risk.

Medicare fraud affects every American. Not only is waste, fraud and abuse taking critical resources out of our health care system, it contributes to the rising cost of health care for all Americans and harms the short-term and long-term solvency of these essential programs.

Eliminating fraud will cut costs for families, businesses and the federal budget and increase the quality of services for those who need care.

The U.S. Department of Health and Human Services (HHS) and U.S. Department of Justice (DOJ) are working together to help eliminate fraud and investigate fraudulent Medicare and Medicaid operators who are cheating the system.

Attorney General Eric Holder and HHS Secretary Kathleen Sebelius are taking the fight against Medicare and Medicaid fraud to a new level. They have committed senior officials from HHS and DOJ to work together on the Health Care Fraud Prevention and Enforcement Action Team (HEAT).

Read Remarks as Prepared for Delivery by Attorney General Holder on New Medicare Fraud Initiative at a Press Conference with HHS Secretary Sebelius (05-20-09)

The HEAT Team will expand efforts to stop fraud and prevent it from happening in the first place. These efforts will include:

Stopping Those Who Perpetrate Fraud:

* Continuing to utilize Strike Force teams that fight fraud in Miami and Los Angeles;
* Creating Strike Force teams in Detroit and Houston; and
* Helping State Medicaid officials conduct provider audits and monitor activities to detect fraudulent activities.
* Using modern technology to complete in a matter of days analysis of electronic evidence that previously took months to analyze using traditional investigative tools.
* Background on the Health Care Fraud Prevention and Enforcement Action Team
* Criminal Prosecution as a Deterrent to Health Care Fraud (PDF – 89 KB), Testimony of Lanny Breuer, Assistant Attorney General for the Criminal Division, before the Senate Judiciary Committee’s Subcommittee on Crime and Drugs, 5/20/2009
* Attorney General Holder and HHS Secretary Sebelius Announce New Interagency Health Care Fraud Prevention and Enforcement Action Team

Preventing Fraud:

* Building demonstration projects focused on Durable Medical Equipment. These projects will increase site visits during enrollment so we can block out imposters and make sure criminals aren’t posing as real providers;
* Increasing training for providers on Medicare compliance and offering providers the resources and the knowledge they need to help identify and prevent fraud;
* Improving data and information sharing between the Center for Medicare & Medicaid Services and law enforcement so we can identify patterns that lead to fraud.
* Strengthening program integrity activities to monitor and ensure Medicare Parts C (Medicare Advantage plans) and D (prescription drug programs) compliance and enforcement; and
* Working with Americans to identify fraud via hotlines and Web sites.

Future Happenings – Stay Tuned:

* New initiatives will be added in the weeks ahead;
* Look for a new HHS/DOJ joint Web site that will track the progress of these efforts; and
* New strategies for involving and getting the word out to the public.

Information Source