Feds recouped $3.1B in false claims. 5 things to know


The Healthcare Fraud and Abuse Control Program returned a total of $3.1 billion in 2020, according to an Office of Inspector General report released yesterday. It’s the highest return on investment into the investigative program since 2016.

Five things to know:

  1. The program investigated 578 criminal actions and 781 civil actions, which includes false claims, related to Medicare and Medicaid.
  2. More than $2 billion went back to the Medicare Trust Funds.
  3. Prosecutors won or negotiated over $1.8 billion in healthcare fraud judgments and settlements in 2020. Compensation for damages to federal agencies made up $572,109,980 of these returns.
  4. Criminal convictions resulting from these actions led to 891 people being excluded Medicare and Medicaid. In total, 2,148 people were excluded from healthcare programs in 2020 for reasons like abusing patients and state healthcare licenses being revoked.
  5. The Justice Department opened 1,148 criminal and 1,079 civil healthcare fraud investigations during the year. About 440 defendants were convicted of criminal healthcare fraud.


Source: modernhealthcare.com

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