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OIG Health Care Fraud and Abuse Control Program Report Issued

The FY 2010 Health Care Fraud and Abuse Control Program Report was issued on January 24, 2011 by the Office of Inspector General (“OIG”). This report summarizes the health care fraud prevention and enforcement efforts that yielded results during fiscal year (“FY”) 2010. According to the Report, the federal government recovered more than $4 billion in taxpayer dollars as a result of health care fraud prevention and enforcement efforts. Over $2.5 billion constituted recoveries under the False Claims Act, the largest amount in the history of the Department of Justice (“DOJ”).

The Report notes the enhanced coordination between the Department of Health and Human Services (“HHS”) and the DOJ, specifically acknowledging the HEAT program and Medicare Fraud Strike Forces. In FY 2010, there were seven cities with Strike Force Teams. The Strike Force Teams’ accomplishments include the following:

• 140 indictments involving charges filed against 284 defendants who collectively billed the Medicare program more than $590 million;

• 217 guilty pleas negotiated and 19 jury trials litigated, winning guilty verdicts against 23 defendants; and

• Imprisonment for 146 defendants sentenced during the fiscal year, averaging more than 40 months of incarceration.

The Report notes that the Affordable Care Act provides the federal government tools and resources to fight fraud, including funding in the amount of $350 million for Health Care Fraud and Abuse Control Program activities. Some of these tools include enhanced enrollment requirements, data sharing across government agencies, and expanded overpayment recovery efforts (e.g., the expansion of the federal recovery audit contractor (“RAC”) program).

For more information, please contact Adrienne Dresevic, Esq. or Carey F. Kalmowitz, Esq. The attorneys of The Health Law Partners can be reached in our Detroit area office at (248) 996-8510, in our New York office at (212) 734-0128, and in our Atlanta office at (770) 804-6475.

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