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Crime Doesn't Pay

Summary: 
Crime doesn’t pay when it comes to defrauding Medicare or Medicaid -- but our crime-fighting efforts do. Over the past three years, every dollar we’ve invested to fight fraud and abuse has returned $8.10 to the American taxpayer.

Crime doesn’t pay when it comes to defrauding Medicare or Medicaid. But our crime-fighting efforts do.

Over these past three years, every dollar we’ve invested to fight fraud and abuse has returned $8.10 to the American taxpayer. We recovered a record-breaking $4.3 billion last year and $19.2 billion over the last five years.

Today, we released a joint HHS-Justice Department report that tells more of this story. Click here to read it.

Fraud recoveries from 2005 through 2013

Let me give you a couple of examples:

  • In Los Angeles, the owner and operator of a medical supply company was convicted in an $11 million scheme to convince seniors to accept power wheelchairs and other equipment that they did not need. He had hired street-level patient recruiters to prey upon seniors at swap meets and other public places.
  • In Florida and North Carolina, 13 individuals were sentenced for their role in a $63 million scheme -- a company was paying kickbacks to the owners and operators of assisted living facilities for unnecessary services (some of which weren’t even provided!). The defendants were sentenced to 24 to 168 months in prison.

Cases like these will put other potential fraudsters on notice that the government will go after anyone who would steal from our most vulnerable neighbors, friends, and families. A majority of funds recovered by the government goes right back into providing better care and addressing fraud.

Our ultimate goal, of course, is to prevent any taxpayer dollar from going to waste. We have more to do to reach that goal. But today’s report shows that we’re making substantial and significant progress in the fight against health care fraud.


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