Feds “Relentlessly” Pursuing Medicare Fraudsters, Recovered Record $4.2 Billion in 2012

Medicare fraudsters, beware: In their combined efforts to combat healthcare fraud, the Departments of Justice (DOJ) and Health and Human Services (HHS) reported record-breaking recoveries for 2012 and they’re not done cracking down. 

The government teams recovered $4.2 billion in taxpayer dollars last in the last fiscal year, according to a report by Attorney General Eric Holder and HHS Secretary Kathleen Sebelius.

Additionally, for every dollar spent on healthcare-related fraud in the last three years, the government recovered $7.90—the highest three-year average return on investment in the 16 years the Health Care Fraud and Abuse (HCFAC) Program’s history.


“In the past fiscal year, our relentless pursuit of healthcare fraud resulted in the disruption of an array of sophisticated fraud schemes and the recovery of more taxpayer dollars than ever before,” said Attorney General Holder. 

The findings from 2012 represent an increase from the nearly $4.1 billion in FY 2011, and are part of a greater initiative enacted by President Obama to eliminate fraud, waste and abuse in the nation’s healthcare system. The recovered $4.2 billion from last year was made possible by a joint collaboration between DOJ, HHS and the Health Care Fraud Prevention and Enforcement Team (HEAT).

Since its inception in 2009, the Health Care Fraud Prevention & Enforcement Action Team (HEAT) have been dedicated to sniffing out health care fraud among individuals and entities abusing the health care system, and ultimately, costing taxpayers billion of dollars. 


The $4.2 billion was returned to the Medicare Trust Funds, the Treasury and other in FY 2012, the report notes. The feds identified 150,000 ineligible Medicare providers by screening those participating int he program in 2012, and recovered $3 billion through settlements and judgments through whistle-blower claims. 

“Our historic effort to take on the criminals who steal from Medicare and Medicaid is paying off: We are gaining the upper hand in our fight against health care fraud,” said Secretary Sebelius. “This fight against fraud strengthens out integrity of our health care programs and helps us fulfill our commitment to our seniors.”

In FY 2012, the DOJ opened 1,131 new criminal health care fraud investigations, resulting in the convictions of 826 defendants.

Written by Jason Oliva