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April 13, 2018 at 12:00 PM
(Photo : Diego M. Radzinschi/ALM)
Federal agencies recovered more than $2.6 billion in health care fraud and abuse judgments, settlements and other fees in 2017, according to a new government report.
The funds were recovered from prevention and enforcement actions against individuals and organizations engaged in alleged fraud against Medicare and Medicaid and other government programs.
(Related: Former Health Insurer General Counsel Gets 6 Months in Prison)
The U.S. Justice Department and U.S. Department of Health and Human Services targeted providers who, among other offenses, operated pill mills out of medical offices and filed false claims for ambulance services and for physical and occupational therapy. In other cases, drug companies were charged with paying kickbacks to medical providers and to pharmacies, and pharmacies were charged for soliciting and accepting kickbacks.
The figure represented a decrease from the $3.3 billion in judgments, settlements and impositions the government said it had recovered in fiscal year 2016, but more than the $2.5 billion recovered in FY 2015. HHS officials said there was a reduction in large monetary settlements from last year because many of the “large pharmaceutical manufacturers have entered into corporate integrity agreements with the HHS office of the inspector general to establish protections against fraudulent activities.”
According to the report for 2017, the Justice Department opened 967 new criminal health care fraud investigations in which federal prosecutors filed criminal charges in 439 cases with 720 defendants, A total of 639 defendants were convicted of health care fraud-related crimes in fiscal year 2017, according to the report.
