HHS Secretary Reports on Health Care Fraud Prevention Progress
Secretary of Health and Human Services Kathleen Sebelius reviewed significant achievements in the fight against health care fraud during a speech at the Chicago Fraud Prevention Summit today.
In his introduction, U.S. Attorney General Eric Holder noted that during the last fiscal year alone, efforts by the Justice Department and HHS recovered nearly $4.1 billion in funds stolen or taken improperly from federal health programs across the country. Holder called this accomplishment "unprecedented."
The agencies' ability to collaborate and analyze claims and other data to identify emerging fraud patterns though a joint initiative known as HEAT - the Health Care Fraud Prevention and Enforcement Action Team - has given the nation's health care fraud prosecution and prevention efforts much needed momentum.
Three years ago, the nation was "falling behind" the scammers who made "easy money" by submitting false claims and collecting payments, often at the expense of vulnerable seniors, Sebelius said. Today, the HHS has a comprehensive database that systematically screens current and prospective providers against provider licensing and criminal records.
"I am proud to announce today that we have already removed 3,000 ineligible providers from the Medicare program identified in just the first month of these new screening procedures," Sebelius said.
She also cited new data analysis tools that allow HHS to analyze claims in real time and freeze questionable payments as another line of defense against those criminals who do find their way into the system.
Educated and informed consumers are on the frontlines of fighting fraud, Sebelius emphasized, and she praised the outreach efforts of Senior Medicare Patrol volunteers who give communities tools they need to recognize, resist, and report fraud.
"No one group, agency, or business owns all of the resources or expertise we need to keep criminals out of the healthcare system," Sebelius said. "Because we all have a stake in preventing health care fraud, we're all doing our part."