• HHS and DOJ Release FY 2007 Report of the Health Care Fraud and Abuse Control Program
  • January 12, 2009 | Author: Michael E. Paulhus
  • Law Firm: King & Spalding LLP - Atlanta Office
  • On December 2, the Department of Health and Human Services and the Department of Justice released the annual report of the Health Care Fraud and Abuse Control Program (HCFAC), which reports the program recovered $1.8 billion for federal health care programs in fiscal year 2007, with a cost to administer the program of almost $250 million.

    The report describes the success of the Medicare Fraud Strike Force created in Miami, Florida, which targeted improper billing for durable medical equipment and HIV infusion therapy. The strike force brought together federal, state, and local law enforcement, resulting in 74 cases and the indictment of 120 defendants in the seventh month period the strike force operated. This program appears to have had a significant deterrent effect, as a dramatic reduction in billing and payments for Medicare Part B was seen during the operation of strike force. Among other enforcement efforts, the report highlights HCFAC’s continued focus on the pharmaceutical industry and describes significant recoveries from manufacturers for improper promotional activities.

    The report on HCFAC’s activity follows DOJ’s press release in November 2008 that $1.34 billion had been recovered under the False Claims Act in FY 2008, of which $1.12 billion or 84% were from health care entities, indicating that the health care industry remains the principal target of government fraud enforcement activity.